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When Partners Become Parents: Using Pact to Create a Birth Bubble

Patricia Williams, LCSW
Westchester, NY & Vermont
PACT Level 2
patriciawilliams.net

As a couple therapist, it has long been a passion of mine to help couples prepare for the birth of a child, not only prenatally but post birth, as well. There is substantial evidence that marital satisfaction declines when couples have children, and early interventions to counteract that are lacking (Cowan & Hetherington, 1991). In my experience, few couples are prepared for how pregnancy and the addition of a third (or subsequent children) will challenge their relationship and what they can do to make it an optimal experience as a foundation for themselves and their family. 

I love the term birth bubble. Jen Pifer, who works as a doula and is also well versed in the principles of PACT, used those words to describe what she strives for when assisting in childbirth. When asked if she would add her voice to this article, she said, “My goal is to help couples become scaffolding for each other and to identify that structure as something they can nurture and maintain.” 

Most pregnancy/birth-related professionals are not trained to help pregnant couples build on their relational strengths, assess and manage their natural apprehensions, and create safety and a secure bubble. A birth bubble can strengthen the relationship and thus increase security and safety neurobiologically and emotionally in utero and beyond for the infant. Jen, for example, told an expectant father, “She knows birth, but you are the expert on her. Together, we will look for signs that her pain has become suffering.” 

A growing body of multidisciplinary research supports the idea that optimal human development occurs within relationship from the beginning (even preconception). Birth and bonding are a critical developmental process for the parents and baby and form core patterns with life-long implications (Weinstein, 2016).  

Lila and Sam are a high-functioning couple in their early 40s, married for 8 years. They are pregnant with their first child. They were referred to me by their midwife, who was concerned about Lila’s anxiety and her reports of tensions between herself and Sam. I can see their strengths as a couple: they maintain eye contact, express their deep love and appreciation for one another, and seem to operate as a two-person system fairly well. They collaborate when telling a story and understand the importance of having each other’s back. As they describe the tensions between them, they seem to have some difficulty soothing each other, as well as finding the baby in each other.  

Given the shortness of time before their due date, I want to help them reveal their fears. I decide to use the PACT intervention Lover’s Pose. Following my instructions, Sam lies in Lila’s lap, where he gazes into her eyes and begins to share his worries of not being enough when she will need him. At first Lila is awkward and not sure what to do. With a little prompting, she strokes his head and quietly reassures him that she trusts him more than anyone in the world. She says how much she appreciates and needs him, and that it is okay for him to be afraid.  

Then they switch positions. Lila with some difficulty shares her fear of how Sam will react to seeing her at her most vulnerable, both emotionally and physically. She reaches for him and weeps in his arms. He reassures her that she will be safe with him. He affirms that her vulnerability makes him feel closer to her and says how much he loves her body as it is and that he wants more than anything to be her rock in this process. He tells her that he is her king and will make sure that both she and their child will have the most support possible. They agree to make sure that when the delivery time comes, all the supporting professionals in the room understand they need to be able to lock eyes and have contact with each other.  

At the end, Sam and Lila talk to their baby and tell him they can’t wait to meet him and are so grateful to be his parents. Although these two have more work ahead, it feels as if they are on their way to providing real safety for each other, and through that, for their new family.  

Jen says the best birthers are couples who rely on how strong and capable they are together. Inevitably, she says, birth asks couples to embrace the unknown. It asks them to be flexible and exposed, to accept “not getting it right” and being totally vulnerable together. “Wouldn’t it be great,” she says, “if we could reach couples during this time in their lives, as they prepare for the birth of their child, when they feel most vulnerable and ripe for guidance, information, tools.” We believe the PACT principles can help not only couples but also birth professionals make this possible  

 

References 

Cowan, P., & Hetherington, M. (1991). Family transitions. Hillsdale, NJ: Lawrence Erlbaum. 

Weinstein, A. D. (2016). Prenatal development and parents’ lived experiences. New York, NY: W.W. Norton. 

 

 

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The Gift of Win-Wins for Couples Who are Parents

Kara Hoppe, MA, LMFT 
PACT Level 2 
Los Angeles, CA 
karahoppe.com 

I recently became a parent to a beautiful baby boy, and I can speak from my own experience when I say that the struggle of mothering and coupling is real. I now have a new appreciation for the complexity and depth of parenting and partnering. By bringing that experience to my work with couples who are parents, I have found that honing in and practicing win-wins are two of the many PACT skills key to supporting a couple as parents. 

Negotiating win-wins (i.e., where both partners win) can be a game changer for couples, especially couples with kids. It takes courage to ask for what we need as individuals and parents, and asking for what we need/want is fundamental to achieving a win-win. This process can lead to a secure-functioning relationship for the couple and to individuation for each partner. The couples I work with love win-wins because the goals are not to compromise but to be open and honest about what each partner wants, to be flexible and creative with each other to arrive at a win-win, and then to claim that win-win. Additionally, there are no victims/martyrs in win-wins. 

Rose and Will have a 3-year-old girl, Joy, and are struggling with their couple connection. They present wanting communication tools, but as I cross-question, cross-track, and cross-comment, I realize that part of the reason both partners feel so lonely is that they have no win-wins. Each solution or decision they arrive at has a winner and a loser. This pattern goes back before they were parents and before they were partners, but it has been amplified due to parenthood.  

I introduce the concept of win-wins to Rose and Will, and they get excited at the idea of both getting some version of what they want. Also, they marvel that they have never considered that a possibility. Will is naturally very funny and exclaims, “I thought I would always get what I wanted, and Rose would always be pissed at me.” They both laugh, so I joke about how fun that sounds. Then I press further: “So that’s the jam? Rose yields to your needs and harbors resentment, and you let this continue?” Will stops laughing. “Yeah. Sometimes. Actually, often.” I continue to press: “How do you know she’s not happy about the decisions you guys make?” Will has an ready answer: “Because she becomes cold and snappy with me.” I turn to Rose: “Is this true?” She cops to it. I suggest we use our time to try something different and I encourage them to pick an easy way to practice finding a win-win. They decide on their morning routine.  

Rose begins by whining: “You get to sleep in and I don’t, and on top of having to get up early with Joy, I’m always late to work. No win-win here!” I help Rose find clarity on what she wants: “Do you want Will to wake up with Joy?” “No. I love our quiet morning cuddles.” Then she straightens up in her rolling chair and says, “What I need help with is giving Joy breakfast.” I see fear in her eyes as she waits for Will to response. Before he can say anything, I point this out to Will. He softens and looks down. I do a gentle down the middle: “It’s hard for both of you guys to be vulnerable and ask directly for what you need.” They both nod. Then Will responses in a calm voice, “I can give Joy breakfast, but I need you to let me do it my way.”  

And with that, Rose and Will are engaged in their first win-win in therapy. I’m there to help them find clarity, empathy, and further awareness for themselves and each other, but they are doing the work to arrive at their win-win. The process takes the rest of the session, with a few fits and starts, and has a victorious ending for both Rose and Will. They are proud of themselves and happy with their new morning routine. 

Personally, I can relate to why this is so hard for many couples with children. Without support and psycho-education about win-wins, it would have been easy to get into a lose-lose rut in my relationship post baby. That pressure I—and many moms—feel to do it all can be a relationship killer. Also, it’s hard to stay present to relationship sabotages when there is another being to care for; one or both parents are physically, psychologically, or otherwise depleted; and the relationship itself has changed so dramatically. Parents undergo huge personal transformations during parenthood, and those internal changes shift the entire landscape, so even if a couple were securely functioning before baby, they mostly likely will need some support post baby. It’s important to normalize this for the couples during therapy. I like to share that the skills and principles of PACT have been incredibly helpful in my marriage and that it is a daily practice for my and my partner to be securely functioning. That way, they know they are not alone in the struggle to navigate a thriving coupledom as parents and can relax a bit into the process. Making it a daily practice gives both partners ample opportunities for win-wins.   

 

 

Repairing Misattunement

Inga Gentile, MFT  
PACT faculty 
Bardu, Norway 
http://www.ingagentile.com 

In the PACT model, a priority is placed on experience over interpretation. This is in part because we target the more primitive, less plastic parts of the brain (which are experience driven) when staging interventions that lead to psychological development and behavioral change. Sometimes we stage those interventions, and at other times they occur spontaneously in something the couple themselves do. Either way, PACT therapists pay careful attention to moments that may uncover something previously unknown or to affect change.  

A young couple I saw, Dan and Laura, clearly loved each other very much and were both remarkably high achieving and accomplished in many ways. They also presented as depleted, exhausted, frustrated, and lonely. In other words, what we commonly see in the wake of small daily moments of unrepaired misattunement and subsequent misappraisal, which are the hallmarks of ongoing mutual threat and dysregulation. They rarely laughed together anymore and were deeply isolated from one another.  

Over the weeks of our work together, with an overarching focus on shifting from an insecure model of couple functioning to a secure model of functioning, they began to demonstrate slightly greater flexibility in their interactions with one another. They began to experience slightly more joy and play. In one session, during a tense and frustrating interaction, Dan spontaneously showed the other a short video clip of what it felt like to be them at times in the relationship. It was of a band playing. The band included a drummer. The drummer was giving it his all but could not for the life of him hit the drum kit in time or rhythm with the rest of the band. Moreover, he didn’t even get any better at it, but he also didn’t give up. Dan and Laura both burst out laughing. It was a powerful moment.  

It also marked a shift—the kind of shift we learn to track, tag, and explore that subsequently helps the couple amplify or attenuate. I could see the contemporaneous underpinnings of PACT (attachment theory, developmental neuroscience and arousal regulation) computing in my own brain. In an instant, faster than words, the couple and I were able to harness and amplify this gesture. This drummer seemed to exemplify not only Dan’s difficulty in attuning to Laura but also both his desire and willingness to do so. In fact, it exemplified the difficulty they both had in attuning to one another. We were able to amplify this spontaneous moment and the accompanying affect and shared moment of meeting and use it as a bridge and a springboard.  

This moment demonstrated several aspects of PACT in action: 

  • It bypassed left hemisphere confabulation and went directly to the symbolic and meaning-filled world of the fast-acting right hemisphere.  
  • Because it was a novel and spontaneous experience, reinforced by shared laughter and eye contact, it stood a great chance of subsequently going into long-term memory for the couple.  
  • It was a possible indication that neither partner had significant deficits related to theory of mind and that any momentary lapses of empathy were state driven. 
  • It served a regulatory function and resulted in a state shift for both partners.  
  • It leveled the playing field in that the image was something both partners could relate to. It became in some ways a version of their foxhole. 
  • It helped to shift the preexisting narrative the couple had about who they were and what got them in trouble. It represented tenacity in the face of frustration, and became something they could come back to.  

This moment didn’t magically result in the couple never experiencing moments of misattunement again, but it did contribute to an ongoing shift toward belief in and the real time of experience of secure-functioning principles. It helped to strengthen a sense of mutual responsibility as stewards of the relationship, as well as widen their bandwidth so that fast-acting misappraisals were often slightly slower. This recipe can be enough to mean the difference between ongoing distress without relief and actually getting better together.  

How Secure Functioning Can Help Polyamorous  Couples

Clinton Power, Grad.Dip.Psych.Couns., Gestalt therapist
PACT Level II
Sydney, Australia
clintonpower.com.au
When a new couple present to your practice and reveal they are in a polyamorous relationship, you may find the concept of loving multiple people strange, risky, or even fundamentally fraught with problems. The good news is that PACT principles that apply to monogamous couples can be successfully applied to non-monogamous or polyamorous couples.

Non-monogamous couples have sex with other people but are not interested in pursuing dates, romance, or a relationship with their sexual partners. This is often described as an open relationship. In contrast, polyamorous couples hold the premise that one partner cannot meet all their needs and they want to explore having sex or a relationship with someone else. These couples don’t limit themselves to just one person when it comes to affection, romance, flirting, sex, connection, and love. Different configurations can be used for polyamorous relationships, but the most common has a primary relationship, with other relationships that are secondary, or not as important.

When Jill and Stephen showed up in my consulting room, they had been married for 10 years and opened their marriage at the 5-year mark, after reading about the polyamorous lifestyle. They wanted to introduce more novelty and excitement into their relationship. All went smoothly until a year ago, when Stephen started developing very intense feelings for Sonia, a new secondary partner. Jill noticed the love he felt for Sonia was deeper and more intense than what she had seen him show with his other secondary partners. She started to worry that Stephen was going to leave her for Sonia.

As we explored the configuration of their relationship, I realized Stephen and Jill were breaking many of the PACT principles of secure-functioning relationships including:

Put your primary relationship first before all other relationshipsStephen and Jill reported many examples where both partners had put their secondary relationships before their primary relationship. This had caused hurt, bitterness, and resentment that hadn’t been fully discussed or resolved. In our work together, Stephen and Jill started to prioritize each other, which had an immediate soothing effect on their nervous systems and an improvement in their overall relationship.

Have clear relationship boundaries that support the health of the primary relationship. Jill and Stephen never created a joint rules of engagement for their primary and secondary relationships. This meant they weren’t clear about what was okay and what was not okay when it came to seeing other people, causing regular conflict and hurt. In our work together, they created a joint polyamory agreement that laid out what they were each willing to tolerate and not tolerate in their polyamorous relationship.

Go to your primary partner first with important news or life events. Problems were created because Stephen was sharing important news and life events with Sonia first, and sometimes forgetting to tell Jill altogether. This made Jill think she was no longer the most important person in Stephen’s life and fueled her worry that Sonia was more important than her. Once Stephen stopped doing this, Jill started to feel more valued in their relationship.

Manage thirds to protect the primacy of the main relationship. It emerged that Sonia had been undermining the relationship between Jill and Stephen. Even though Stephen knew this, he hadn’t set a firm boundary with Sonia to protect his relationship with Jill, because he was scared of losing Sonia. Stephen started to set firmer boundaries with Sonia to stop this happening. Sonia stopped the undermining behavior and was able to adapt to the new boundaries set by Stephen.

Never threaten the security of the relationship. Over time, Jill felt more threatened by the relationship between Stephen and Sonia. Her response to feeling insecure was to threaten to end their marriage, which led to Stephen feeling distressed and fearful he would lose Jill. Threatening the end of the relationship was the wrong solution and made both feel more insecure. They both committed to not to threaten the end of the relationship, which helped each feel more secure and stable in their primary relationship.

Resolve conflict by finding solutions that work for both partners. This couple could not find solutions to their issues that worked for both of them. Regarding attachment styles, Stephen was an island and Jill was a wave. As soon as Jill was wave-like, Stephen started to retreat and avoid, leaving Jill feeling more isolated. Over time, Stephen developed his tolerance to her wave-like behavior and learned the value of moving in and soothing her, even when he felt like running away. Jill understood that Stephen’s island-like behaviors weren’t personal, and she learned more effective approaches to resolving issues with him that didn’t overwhelm him.

In conclusion, in my experience, polyamorous relationships can work. However, they may be tricky to navigate, and couples need to ensure they’re applying the PACT principles of secure functioning to their primary relationship. As a therapist, it’s essential you put any biases or judgments you have about polyamorous relationships aside when working with these couples. Initial questions you can ask couples include:

  • Are you okay with your partner developing romantic relationships with others or do you only want sexual interactions with others?
  • Can you have regular sexual partners or do you prefer one-off encounters/hook-ups that are not to be repeated?
  • What’s your policy on sharing your sexual experiences: complete transparency, “don’t ask, don’t tell,” or do tell if you’re asked?
  • What sexual activities are okay and not okay (e.g., oral sex, kissing, and mutual masturbation are okay, but vaginal or anal intercourse is not).
  • What’s your plan for managing safer sex with each other and your other partners?

I encourage you to maintain a stance of curiosity at all times so you can understand the kind of relationship the polyamorous couple want to create. If you apply the secure-functioning principles of PACT, working with these couples can be extremely rewarding as you help them restore healthy functioning and find love in the way they want.

Working With a Couple Who Have a Trauma History

Amanda Woolveridge, M.App.sci.
PACT Level II
Sydney, Australia
amandawoolveridgecounselling.com.au

John yanked open the curtains at 10:30 am. Light flooded the bedroom as he placed their one-year-old baby on Susanne, who looked bleary eyed and confused as she struggled to wake up. “He’s been asking for you,” John said, before he disappeared downstairs. In his role as house husband, he had decided that Susanne, who had reluctantly returned to full time work after 9 months at home, had slept in long enough for a weekend.

The day was not off to a good start for Susanne. She felt shocked into wakefulness, jarred by the sudden noise and light, confused by the instant demands of her little son, and completely abandoned by John. Because of her complex developmental childhood trauma history, all the alarm bells in her amygdala jangled simultaneously. The stage was set for her to have what John calls “one of her episodes.” She came thundering down the stairs to let him have it, which led to him walking away from her white hot anger in an attempt to diffuse the situation. Which, in turn, led to Susanne feeling even more misunderstood and abandoned. While John could return to homeostasis quite quickly, it took Susanne days to recover her equilibrium. She needed resolution; he, on the other hand, needed to shut down to protect himself. As a result, this couple unwittingly triggered a trauma response that set them off course and kept them from secure functioning.

In therapy, I wanted to level the playing field. However, although I tried to go after John’s triggers with the PACT skills of cross checking, cross questioning, and even going down the middle, initially his defenses remained ironclad. Literally: he participates in Iron Man competitions and has the sturdy barrel chest of those who train extensively. He has a crew cut and a chiseled face, with a frequent don’t-mess-with-me expression. He often leans back in his chair, sometimes with hands behind his head, one leg crossed over the other. A man in charge. Susanne, on the other hand, has an oval face, with a soulful, sometimes bewildered expression about the eyes.

During one session, Susanne talked about John’s parental tone, his over-managing of her life, and his confusing use of humor. She often feels criticized, which he deflects by saying he is “only joking,” causing her considerable confusion. At that point, I looked more closely at John, and I was able to see the little boy behind the man-in-charge. This brought to mind the PACT motto “Go after the baby.” John also has a trauma history, with a violent stepfather and a teenage mother who was trying to grow up while raising little John. So I told him I could see how painful it was to think about his boyhood experiences. Which he denied. Nevertheless, that was the first session in which John’s ironclad defenses wobbled. He said he’d had enough and needed to leave. Susanne said she could not go in the car with him in this ominous mood.

She nodded after I invited her to look at John and realize that this was about him staying safe, not about threatening her.

I turned to him and said, “It’s important for you to be safe, John, I can see that. It makes sense that hearing Susanne thundering down the stairs that morning after you left the baby with her caused you to shut down, given what you experienced when your stepfather stomped down the corridor to your room to punch you so violently you wet yourself. I can really see the pain that young boy John was in; it’s here right now in the room. But right now, it’s important to remember that you are well-equipped to look after that boy, be kind to him. This is now and that was then, and this is different.”

I turned to Susanne and invited her to recognize the boy who was threatening to walk out. He was no menace to her, and was not her father at all.

I reminded them both of the PACT principle that they were in each other’s care, and that to walk out wouldn’t help them feel safe. It was important to take a breath and come back to their senses, to this moment, to look at each other’s eyes. Something shifted after this session, and they reported having a really good conversation a few days later about how to take better care of each other. During the next session, they were able to do the PACT exercise called Lovers’ Pose to help them move beyond their defences and their triggers, and build trust between them.

First Things First: The Primacy of Partnership in Blended Families

Jason Polk, LCSW, LAC
PACT Level II
Denver, CO
paramitacounseling.com

There is no magic bullet to maintaining and raising children within a blended family (a family with children from multiple relationships), and I am not an expert in the finer points of day-to-day interactions in a blended family. But while working with couples who have blended families, I have observed that they do better when they follow one basic principle: they hold each other as primary in the relationship—or we could say, as the king and queen of the household.

This may sound straightforward enough, but it is not always easy to put into practice, especially because overt and covert allegiances and alliances are often formed among each partner’s own children within the blended family. In therapy, parents often justify these allegiances and alliances by recounting the numerous difficulties they have been through with their respective children. For example, one partner may feel guilty about how his or her children had to experience several years of a difficult marriage (and ultimately divorce) with the children’s other parent (now the ex). Parents may be overly protective and give preferential treatment and resources to their own children, while neglecting their partner and stepchildren. I have heard one partner say in front of the other, “My child is the most important person to me.”

Fundamentally, there is nothing wrong with this sentiment. Your children should be very, very, very important to you. However, you become a better parent—and thus better able to serve your own children and stepchildren—by making the relationship with your adult partner primary.

The primary partner (the person you married, or are cohabitating with) is the one who is best able to regulate your emotions and best able to take care of you. Children should not be put into a position to take care of their parents, and they are not very good at the job. Partners put themselves in the best position to receive care by demonstrating and expressing to each other that their relationship is primary. If one partner feels demoted, or that he or she is losing to the children, that partner will be less likely to provide support to the other, and consequently, problems are more likely to ensue.

Tom and Jenn came to therapy with the goal of learning communication techniques to deal with their teenage daughter. Tom had a 16-year-old daughter from a previous marriage, and Tom and Jenn have a 4-year-old son together. Tom felt guilt about what his daughter had to endure during his first marriage and what she faces now: a rotating weekend schedule, as well as Jenn’s frustration because she thinks his daughter is wildly disrespectful and entitled.

On the surface this may seem complicated, but it soon became clear that what they needed wasn’t specific communication skills per se, but rather just to hold each other as primary. They had stopped taking care of and supporting each other in favor of becoming entrenched in what they perceived as the best course for parenting within these circumstances. They had grown apart and shut out their most powerful ally for their predicament: each other.

In PACT, there is an exercise called the king and queen pose that is effective with affairs, but I also found it effective for Tom and Jenn. During a therapy session, I had Tom move to his knees, hold Jenn’s hands, and look up into her eyes and say, “You are my queen…” It was as if Jenn had been waiting a very long time to hear something like that. Her demeanor softened, and her eyes became teary. When it was Jenn’s turn, I had her say to Tom, “You are my king…” Hearing this, Tom softened, as well. It was as if he had been waiting a long time to put down his heavy shield.

Thus, the cornerstone of their therapy was to remind each other of their royalty (i.e., to each other as king and queen). Their reactions to the pose signaled what was missing and what they yearned for. Tom and Jenn needed to learn how to take the armor off and allow themselves to be positively influenced by each other—to allow space for their royalty to come through. This involved learning ways to take care of and soothe each other, being the first to know about important matters, as well as understanding that all important family decisions are decided together—including the best way to handle their daughter.

Because they had more appreciation and intimacy in their relationship, they had more resources to work with their daughter. They reported feeling better with their daughter and started to observe improvements in her behavior. Tom and Jenn discovered they were more powerful and effective operating together and making their relationship primary. That was the best thing they could do for their kids.

 

Building Secure Functioning in the Face of Difference

Eda Arduman, Ma.
PACT Level II therapist
Istanbul, Turkey
edaarduman.com

Agreeing to disagree can be easier said than done. Some people believe that their beliefs and values constitute their character, and thus can’t be changed. But a relationship in which change is disallowed will not be successful in the long term. The process of understanding a partner—including the risk of having to change in unexpected ways—can be bewildering. For example, who takes the leadership role? Who follows? The couple must learn to negotiate their differences, as well as any resulting conflicts, while creating and maintaining secure functioning.

I work in Istanbul, a city that bridges two continents, and cross-cultural couples are common in my practice. I want to share one example. Roland is Belgian, and Didem is Turkish. They met while students at a university in London, and have been married for 13 years, with two children. She works as an executive, he as a consultant. They joint parent very well and have no financial problems, and their sex life is fine. However, Didem started to complain about feelings of loneliness. She reported in couple therapy that she gave Roland feedback about how he could communicate better with her and be more expressive, but he resisted her efforts. He, however, insisted there was no problem.
As a PACT-trained therapist, I aim to guide couples toward secure functioning, and to do so in a way that allows them to jointly discover what this principle could mean for them. Instead of taking what a couple say at its surface value, I continually track their neurobiological cues and microexpressions to uncover the truth.

My work with Didem and Roland advanced through three stages as I guided them toward secure functioning. First, we created a relational space that allowed Roland to really connect with Didem’s loneliness.

Second, building on this, Didem was able to realize how lonely Roland himself was, as someone who lives in a foreign country. Because communications between them occurs in what is to him a foreign language, he is never sure if he is on the right track or not. As a result of this dynamic, Didem became more dominant and he became more passive and withdrawn during the 14 years of their marriage.
Finally, I led them in a real-time exercise so they could reflect in a playful way on the polarized patterns of activity and passivity in their relationship. I asked Roland to blindfold Didem and take her on a walk through the room. He barked clear, curt orders at her, and when she resisted, he said, “Trust me.” Each time he mentioned trust, and she followed him obediently, I was reminded of the walk of shame in Game of Thrones.

After they completed the exercise, Didem said she felt safe with Roland and that she loved when he touched her. He looked at me victoriously.
I then questioned why Roland had used curt commands. He said he had no patience for people who don’t trust. At this point, Didem burst into tears and was able to share her feelings of rejection when he treated her in that manner. Until then, she had hidden her frustration because she felt guilt for having moved Roland to her country, and for any unhappiness that caused him. She had let her resentment build in isolation from him. At the same time, he felt increasingly distant and started to passively resist even more. The result was a pseudo-secure relationship that lacked honesty. The ability to tolerate conflict was also lacking.

In terms of PACT attachment styles, Roland was an anchor, veering when under stress toward island, and Didem an anchor veering toward wave. Her fear of intimidating him had caused her to repress her needs for expression. He, on the other hand, needed his space and felt he did not fit into her emotional climate. They were frozen in their assumptions about themselves and each other, and moving farther and farther apart. As a result of therapy, they are now actively seeking ways to allow their joint space to expand so they can feel less threatened by their differences, and can agree to disagree in a manner that enriches their relationship.

The Devil is in the Details

Krista Jordan, Ph.D., ABPP
PACT Level III candidate
Austin, TX
www.kristajordan.com

“He doesn’t find me attractive,” she lamented, eyes cast downward toward his shoes.

My interest as this couple’s therapist was piqued: the woman before me could easily be mistaken for a model. I turned to him and said, “Tell her what you find attractive about her.”

After an uncomfortable pause, he offered, “I like her hair; it’s dark.”

I felt confused. What about her eyes? Lips? She looked even more dejected, focusing intently on the carpet. “What else?” I queried.

He seemed to be searching for a lost item. “Um, her back is really toned.”

I could see her collapsing further, the corners of her mouths starting to droop. “What about her face?”

He paused. “Um, I like her eyes. They’re kind.”

I began to wonder if we had stumbled upon a deficit. I turned to him and said, “Describe your daughter’s face.”

“She has dark hair, and it’s long. And she’s lanky, tall.”

I turned to his wife and asked, “Does he think your daughter is pretty?”

“Oh yes!” she exclaimed.

I locked eyes with her and said, “He can’t describe her face, just as he can’t describe yours. His brain doesn’t do that well. That’s a deficit.” I explained that his brain does not lock onto facial features, and that has nothing to do with her.

She brightened and looked at him for the first time since the discussion began. “So you do find me attractive?”

“Yes! I’ve just never been good at describing people.”

I could see affect rising in her, and turned to him. “What’s going on with her?” I asked.

“She’s sad I have this deficit.”

“No,” she said, “I’m sad because I’m thinking of middle school when everyone was getting crushes, but no one paid attention to me. I thought, ‘I’m never going to get married because I’m not pretty enough.’ In college, I finally got attention. Boyfriends said I was pretty, and I felt maybe I was okay after all. But you never complimented me like that. I dealt with it because you treated me well and I loved you, but it still hurt.”

I turned to him and said, “Do you see the childhood wound?”

“Yes,” he said, moving closer and taking her hand.

“Tell her she’s beautiful,” I said.

He looked right at her and said, “You’re beautiful!”

She still looked like she was holding back a bit, so I asked him, “How did that land?”

“I don’t think she trusts it.”

I said I agreed. “You need to step it up. Tell her how much you love her eyes, her cheeks, her lips.”

He moved in even closer and echoed my words. I saw relief and pleasure in her face, and asked him, “How is she now?”

He said, “She looks a lot better. Happier!”

When this couple left the session arm in arm, they both had a completely new narrative for their past seven years. They also had a new map to navigate this territory in the future. They had shared an experience that was reparative to both of them. He felt understood rather than judged, and felt empowered to do better by his partner with his newfound knowledge. She felt loved in a way that was reparative of a deep childhood wound that no one meeting her today could have guessed existed.

Without using PACT, I would not have been able to facilitate this beautiful transaction. PACT has taught me to look for deficits as well as defenses, and to generate hypotheses about why people act as they do. I test my hypotheses using interactions I can see and track right there in the session. Finally, and most powerful of all, I then share the data I gathered with the couple who just experienced the event. I show them that “the devil is in the details.” With those details, couples who were lost in misplaced narratives about why their relationships were failing can finally heal, and can do so while maintaining the dignity of both parties.

The Poetry of Couple Communication

Susan B. Saint-Rossy, LCSW
PACT Level III candidate
Ashburn, VA
www.relationship-therapist.com

Most couples who come to me identify their main problem as lack of or poor communication. Many times, couples believe that if they just learned to communicate properly, their relationship would be “fixed.” Thus, various therapeutic schools have come up with techniques (e.g., active listening, the use of “I” statements) to give order to a messy, complicated process. From the PACT perspective, these approaches can oversimplify a couple’s situation.

PACT recognizes that communication is complex, nonlinear, and multidimensional—much like poetry. Couples’ communication includes the symbolic language of words, micro-expressions, body language, tone of voice, and other elements. There is no one-to-one correlation between words and meaning, or words and intent.

Considering a couple’s communication with each other to be a poem (with all its symbolism, emotion, heightened sensitivity, and multiple layers of meaning) has helped me understand the PACT therapist’s role and therapeutic stance.

Beatrice and Mel, who are in their fifties and have been married for 18 years, came to me with communication issues as their main problem. The following dialogue occurred in our first session:

Beatrice: Happens all the time over really small decisions or incidents.

Me: (to Mel): Do you know what she’s referring to?

Mel: Yes, but I can’t think of . . .

Beatrice: Like this morning. I asked him if he wanted eggs and toast for breakfast. This one (pointing at Mel) ignored me.

Mel: (very quietly, looking at me, jaw grinding) I said it didn’t matter.

Beatrice: (loudly, with movement in all four limbs) You said it didn’t matter after I asked you at least three times.

Mel: You know what I like for breakfast. So why do you ask? Besides, I can make my own breakfast. You don’t need to make breakfast for me.

Beatrice continued to discuss, with great intensity, how angry she gets when this kind of thing happens. Mel continued to downplay the event, saying Beatrice can get upset about almost anything he does or doesn’t say or do. He just didn’t want her to fix his breakfast. What’s the big deal?

Before I was a PACT therapist, I would have probably lost my patience in this situation. I may have even interrupted because I thought it was going nowhere. Now I know that my job is to look for symbolism; imagery; and evocative language in the words, voice, and nonverbal expressions—to let the poem unfold. I wait, watch, and listen. I take in the emotional tenor of the moment without becoming part of it. I “read the poem” to get my inspiration about what is going on and what to do next.

In this case, I saw that, for Beatrice, asking Mel what he wanted for breakfast is an expression of her wanting to have breakfast with him. Unfortunately, Mel didn’t realize that breakfast is not just breakfast to Beatrice, but is symbolic of much that Beatrice feels she is missing in the marriage.

In poetry, a symbol is an action, object, word, or phrase that takes on a different meaning(s) that is deeper and more significant than the original. In my aha moment with Beatrice and Mel, my contribution to their poem became clear: I could help them understand the richness underneath their communications, as illustrated in this graph:

Screen Shot 2017-08-14 at 12.17.16 PM

Just as a student of poetry looks at theme, structure, symbolism, cadence, rhythm, the poets life, and any other applicable variables, as a therapist, I take in all the couple’s the words, voices, facial expressions, and movements, as well as my own emotional responses. My inspiration comes, and I decide how I can help shape the poem to take the couple to a more safe and secure-functioning place.

 

Using PACT in Individual Therapy: A Pro-Relationship Stance 

Margaret Martin, LCSW, SEP
PACT Level III candidate
Austin, TX
margaretmartinlcsw.com

When I started my career, I was a dyed-in-the-wool individual therapist, with little or no interest in couple therapy. My master’s program offered minimal education in couple therapy, and because I had no plans to pursue that, I assumed my training in couples’ work would end there. But then a friend convinced me that taking the PACT training would help me grow as an individual therapist. What began as a tepid dipping of my toes into the pool of couple therapy evolved into a dive into a deep, fulfilling sea. Not only do I love my work with couples, but my training as a couple therapist has enhanced my work with individuals.

The principles that make up the foundation of PACT apply to all kinds of relationships, not just romantic partnerships. Individual clients bring their struggles with partners, ex-spouses, friends, coworkers, parents, and children. Although the PACT approach helps therapists support individual clients in their romantic partnerships, the fundamental principle of PACT—moving couples toward secure-functioning relationships—also applies to a variety of relationship dyads.

Couple therapists sometimes describe encounters with individual therapists who seem to unintentionally undermine the work of couple therapy. This occurs most frequently when an individual therapist, in an effort to support a client, backs the client by throwing the client’s partner under the bus. This does a grave disservice to the client and can be detrimental to the couple relationship. In contrast, individual therapists trained in PACT offer a more balanced perspective when helping clients with difficult relationships, even if seeing couples never becomes part of their practice.

The PACT model supports therapists taking a pro-relationship stance. This means a belief in putting the needs of the relationship first, before individual needs. Being pro-relationship includes an understanding that in a healthy relationship, what’s good for one is good for the other. Having adopted this mindset, I look at the dynamics of relationships differently than I did in the past. Consequently, I have a different approach with individual clients regarding their relationships. When I take a pro-relationship stance, I avoid blaming one individual for relational discord, and recognize instead that both parties in the relationship contribute to conflict and misunderstandings. By bringing my pro-relationship stance to individual sessions, I better help clients test old beliefs about relationships and develop new ways of looking at their partners and their relationship dynamics.

Before becoming a couple therapist, I periodically bought into my individual clients’ narratives about their partners. In those instances, I accepted at face value the client’s description of his or her partner as being insensitive, lacking empathy, or being just an out-and-out jerk. In so doing, I was complicit in the client’s drawing of a line in the sand of the relationship. I hadn’t learned to ask classic PACT questions, such as, “What do you know about your partner’s childhood that would make him respond that way? Who treated him like that as a child?” In couples’ sessions, PACT therapists use these kinds of questions to help couples look beyond the knee-jerk reactions they have to their partner’s behavior (“he’s a jerk”). They begin to see any number of other possible explanations for a partner’s unwanted behavior. For example, one partner may realize that his wife’s inability to apologize and make a repair following an argument stems from no one ever having done that for her as a child, rather than “she’s a jerk.”

I now use this same curiosity and inquiry with individual clients regarding their complaints about partners (and siblings, coworkers, friends, parents). As a result, I see the change in clients’ negative views of their partners. By challenging their narrow assumptions and tendency to label, clients develop a better understanding of their loved one. This shift in my approach helps clients develop their own pro-relationship stance and move toward secure-functioning relationships.