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Allison Howe, LMHC
PACT Level II
Saratoga Springs, NY
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.
Inga Gentile, MFT
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.
Tatkin, S. (2012). Wired for love: How understanding your partner’s brain can help you defuse conflicts and spark intimacy. Oakland, CA: New Harbinger.
by Carolyn Sharp, LICSW
PACT level 3 candidate
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.
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.
Partners caught in ongoing distress lose sight of how to shift their negative dynamics. Although their dance could change if either made a small but significant move, neither seems to know a move to take things in a positive direction. So rather than acting from a sense of agency, each feels powerless and at the effect of the other.
From a PACT viewpoint, we maintain that each partner has the power to change their mutual dance. We know that, as primary attachment figures, they have a great deal of influence and hold a uniquely powerful position in each others’ brains. Each has the potential to sway the other in a new direction. Part of our work is to expand the repertoire each brings to the dance floor. We point out where they inadvertently step on each other’s feet and demonstrate in real time how a different move here or there relieves distress and helps them feel more connected.
PACT presupposes such moves can be made. In fact, we expect partners to make them and wonder, often aloud, why they don’t. Typically, each professes ignorance over steps to take that would reduce distress. Having no idea about what else to do, an avoidant husband yet again automatically backs away from his wife’s snarky remarks or harsh tone. Or she, acting out angry protest, doesn’t seem to know how to reach for him in a way that pulls him to her, so instead pushes him away.
In PACT, we assume they have it in them to take counterintuitive steps that will lead them to a secure dance. And, like a choreographer, we nudge them in that direction. We instruct them overtly, suggesting moves such as “Get closer, hold hands, gaze into each other’s eyes….” There is also utility in assuming the moves already lie dormant within them, simply waiting to be awakened. I love to uncover hidden resources within partners by presupposing they already exist.
For instance, if they have kids and I already know they provide secure attachment responses to their children, I usually can bank on the mind-altering question “What would you do if this were your precious three-year old child ______?” filling in the blank with whatever behavior seems to be triggering (e.g., crying, throwing a fit, accusing you of being a bad parent, pulling away, hiding in his or her room).
I have been amazed to see how quickly this simple query can add new steps to the dance. For example, the avoidant husband above may move on his own initiative toward his angrily protesting wife and feel renewed strength, empathy, value, and importance as he holds her, reassures her, and calms her—a move he usually made with his daughter, but never conceived of with his mate. At this point, discussing how a younger part of the brain takes us over is often a useful way to strengthen the probability of future caring responses.
It can be profitable to assume people have the inner resources for positive change, but don’t yet quite realize how to hook these up and enact them. Dormant brain circuitry can be plugged in, reweighted, and brought online in their partnership. PACT operates from these kinds of powerful presuppositions. We assume each partner has the power and ability to have a positive impact in their dynamic. We realize how important each is to the other’s brain once they have been elected to the post of primary attachment figure. Knowing infant-caregiver attachment research, we realize the power of the moves partners can make once they fully realize they are in each other’s care. Like patient choreographers, we keep nudging them to dance more securely together.
Copyright John Grey