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By Kate Balestrieri, Psy.D., CSAT-S, CST
PACT Level 2 Therapist
All couples fight. Therapists know this. Couples (most couples) know this. But in the moment, it feels like annihilation for a couple ill-prepared to stay attuned and remain committed to a secure-functioning endeavor.
Disagreements and fights are healthy, and the Psychobiological Approach to Couples Therapy (PACT) model works with couples to help them preserve their relationship and fight in a manner respectful to one another and the bond they share. Tatkin (2018) notes the crux of disrupted efforts to remain coregulated and attuned during a fight are the brain’s
- negativity biases;
- insecure attachment patterns.
Regressions into fight, flight, or freeze can occur and, if left unrepaired, can become the status quo as partners unconsciously or consciously perceive threats to the sustainability of their relationship.
Insidious old habits related to self-protection die hard. They can impale longevity of any couple, if they are not keyed in to attunement and coregulation opportunities during conflict. That is where the PACT therapist can help.
Couples fight about sex and money but are not always aware of how they weaponize sex and money in their fighting. Carnes (2015) refers to the fusion of sexual thoughts and behavior with anger as eroticized rage. Fellow PACT therapist, Debra Kaplan (2013) coined the term monetized rage to depict the expression of anger through financial betrayal.
From a PACT lens, the weaponization of sex and money can introduce poorly managed thirds into a coupleship, wedging these two essential elements of relational survival between partners, and obfuscating authentic intimacy.
Insecure Attachment Patterns
The obvious examples of such rage are events like extramarital affairs and hiding money from a partner. More commonplace are the not-so-obvious moves that perpetuate a ripple effect of impulsive self-protection, relational implosion, and distancing. In the moment, the protective self tracks a win, but the result of that win thwarts the very security said strategies aimed to achieve.
In hindsight, it can be a real biting of the nose to spite the face effort. But self-protective and adaptive strategies persist. Eventually, couples call a PACT therapist to help them identify when those unmet needs or fears compel such behavior and to guide them into protecting each other, ensuring the long-term survival of the coupleship and long-term self-protection.
Any commoditization of a partner’s worth, financially, sexually, or otherwise in service of one’s own ego can volley a devasting blow to the coupleship. Safety is breached because one partner has consciously, or unconsciously, chosen to objectify the other.
What makes this act even murkier? The lines of appropriate boundaries, or safety needs for secure functioning, are different within each coupleship and, likely, for each partner.
Sociocultural influences, such as religious values, gender role expectations, and racial and economic factors make some acts a declaration of rage or war, while others an expectation and demonstration of loyalty.
Helping couples discover and navigate the lines together is the dance of the PACT therapist. It disentangles unconscious expectations within the dyad to establish a new social contract; one built with explicitly outlined principles of governance. Volitional agreements are key. Often the fear of conflict compels placation, which begets resentment, anger, and rageful acts.
PACT therapists are cued into the couple’s implicit and explicit agreements. They challenge any such pseudo-activation in service of breaking old neurobiological and attachment-based defaulted dynamics.
Consider Richard and Jennifer. Asian-Americans in their early forties, they are outwardly the quintessential couple: big house, expensive cars, designer clothes, healthy and high-achieving children. Their friends are effusive with envious praise. Born in the states, they both report feeling more American than Asian, yet both endorse unwavering loyalty to cultural expectations of gender roles, wealth derivation, and conflict avoidance.
In their 10 years together, the couple has weathered a few storms, including financial turbulence, infertility problems, and multiple infidelities. Her hefty shopping sprees and abject disregard for the couple’s agreed upon budget followed each of his sexual betrayals and were conscious endeavors to even the score.
In their first session, Richard remarks that he is “not mad” at Jennifer for spending $25,000 on a handbag following the discovery of his most recent affair and says he “deserved it.”
Jennifer’s father is alcoholic, demanding and petulant. Her mother is quiet but endlessly critical: Jennifer isn’t “pretty enough.” She has “let [her]self go” in recent years. Her mother and husband constantly criticize her post-partum body and fashion choices. Jennifer feels worthless, not valued by her husband, family, or cultural community.
Richard’s father is medically compromised and lives abroad. His mother is harsh and was unavailable through his childhood years. She questions Richard’s professional competence yet requires him to be financially responsible for his three younger sisters when their respective marriages ended. Financial objectification was a burden placed on Richard early in life.
The volume of thirds present for Richard and Jennifer are plentiful, yet neither partner is willing to set boundaries with their families or to prioritize secure functioning within their dyad.
When invited to outline their shared principles of governance (Tatkin, 2018), both partners readily align their sole priority around image and impression management: being seen as successful and “having it all together” to avoid bringing shame to themselves or their families. Unfortunately, this does little to engender secure functioning.
Being seen as the perfect, wealthy couple requires them to act in direct opposition to what would meet their relational needs: authenticity, connection, and attunement. Here is where the PACT magic begins.
Over the first several sessions, it becomes clear that Richard is an island and Jennifer an obvious wave. Richard remains stoic and seemingly frozen. Jennifer cries frequently and dramatically in sessions. They act in parallel, refusing to make eye contact for the first three sessions, even when invited to do so.
To the outside observer, these shared responses may look like fear, shame, cultural default, or avoidance, and may be all of the above. Nonetheless, when their behavior is brought to light and reframed as joining, they both smirk and, for the first time, they lock eyes in session.
From this point, the couple feels safer. As a result, they quickly dive into a long list of resentments and injuries to their sense of secure functioning, all originally wielded at one another in the form of sexual and financial exploitation and withholding.
Using the five-minute argument (Tatkin, 2018), Richard and Jennifer go frame by frame with each other to recount a series of events. They maintain eye contact and stay individually and co-regulated. Both invested in problem solving, they have the fight they needed to have years ago because they are now able to safely self-activate and immediately address any felt ruptures. Creating containment with the exercise and a platform for mutual attunement, this couple is able to benefit from the framework of the PACT model.
Carnes, P. (2015). Facing the Shadow: Starting Sexual and Relationship Recovery, Third Edition. Carefree, AZ: Gentle Path Press.
Kaplan, D. (2013). For Love and Money: Exploring Sexual & Financial Betrayal in Relationships. CreateSpace Independent Publishing Platform.
Tatkin, S. (2018). We Do: Saying Yes to a Relationships of Depth, True Connection and Enduring Love. Boulder, CO: Sounds True.
By Kara Hoppe, MA, LMFT
PACT Level 2 Therapist
As a couple therapist, I’ve learned that relationships are like fingerprints: each one is unique. Even though each couple reaches out for couple therapy for a variety of reasons, they all, at some point during our initial consultation, ask for the same thing – communication tools.
Communicating with your partner can be downright difficult. Some topics are hard to talk about so partners stay silent, which can create a sour divide in the partnership. Or, topics are so emotionally charged that each conversation becomes a boxing match. This combined with the modern jam-packed, full-tilt, boogie busy lifestyle that many of us occupy, it’s no wonder that couples are struggling with a capital S.
In this and my next PACT blog, I’ll be sharing communication tools you can use in your relationship right now. This post focuses on speaking. The goal is to speak directly, clearly, and kindly so you can successfully communicate your needs and desires to your partner. My next blog post will focus on effective listening. In quality, effective, and productive communication, both parts are essential.
So, speaking of speaking, how do couples stop dishing out negative communication – critical and shaming on the speaker side, lazy and defensive on the listener side?
Set the Tone
Many conversations begin with a need, request, or desire from one partner. Assuming that neither partner has magical mind-reading powers, these conversations happen often in long-term partnerships. One partner becomes aware that they want something from the other partner. For example, they want their partner to help out with dinner more often; or, they land a big promotion – yay! – but their workday hours will be longer – boo! – so they need their partner to do all drop-offs and pick-ups for the kids; or, they feel disconnected and are concerned for the wellbeing of their partnership.
All great reasons to talk to your partner. As the speaker, set your tone in your mantra. Sometimes before I choose to have a potentially tricky conversation with my husband, I’ll repeat this mantra to myself: I am direct, clear, and kind with my wants, needs, and desires. It grounds me and helps guide me through our conversation. I encourage you to adopt mine or craft one of your own.
Start with “I”
Direct, clear, and kind conversations involve “I” statements:
- “I am so excited, and if I’m honest, I’m a little overwhelmed by this promotion. I need your help.”
- “I feel lonely and disconnected from you, and I don’t like it.”
- “I don’t enjoy making dinner every night. I want to switch off nights with you.”
Notice the clarity that naturally occurs when making an “I” statement. It’s all about the speaker and the speaker’s experience. It does not blame or shame. It’s not passive-aggressive.
“I” statements help speakers be vulnerable and speak directly. An “I” statement is not, “I feel that you’re not helping with dinner because you don’t appreciate that my time is as valuable as yours.” That statement is more about assumptions and blame. The speaker isn’t taking responsibility for their own feelings.
Making an “I” statement is powerful. And making an “I” statement can also be hard. Sometimes the difficultly lies in the fact that no one modeled this useful tool in the partner’s first family or family of origin. A skill is hard to learn if no one ever teaches it.
Create a Code Word That Matters
Another reason why “I” statements can be challenging is the sheer vulnerability inherent in this form of communication. Using “I” allows the speaker to take full responsibility for their own feelings – and for their wants, needs, and desires. If that person doesn’t have a history of their wants, needs, and desires being of value in their first family, then they will probably be afraid to speak directly and consciously. Unconsciously, they may want to hide their vulnerability behind shaming or criticizing their partner. If this is you, I have another tool for your arsenal.
This tool seems simple but sometimes even I forget to use it:
- Ask your partner for help.
- Alert them that this is hard for you.
- Agree on a code word.
My husband and I use the word vulnerable. When either of us use this alert, we know that one of us is pushing ourselves and may need help. Sometimes I preface a request from my husband with, “I’m feeling really vulnerable. This is hard for me to talk about with you, but I know it’s important that we talk about everything together so here we go.” When I bust out our code word, he’s on the same page, and we’re teaming it up.
Team Up for Success
Since hard conversations can already be challenging, set yourselves up for the best chance at success. Remember what’s important:
- Limit distractions.
- Place yourselves face to face.
- Wave a friendly flag at each other.
It’s nice to say something authentically kind to your partner. It can be as broad as “I love being married to you” or as detailed as “I really appreciate how you set up our patio last night and barbecued for everyone. You hosted our friends so lovingly. Thank you.” Just make sure your message is sincere.
If you’re not feeling any appreciation for your partner, don’t fake it. See if you can make your eyes warm and inviting. It may be helpful to evoke a memory where your partner helped you out or made you feel loved. Just pausing and remembering moments of connection can often soften us. Remember that you want to get to the other side of this conversation together.
Keep in mind that using “I” statements, asking for help from your partner in real time, and talking face to face may be a new experience for you guys so be sure to celebrate victorious direct communication together when it happens as a way to encourage more direct communication together.
Be gentle with yourselves as you learn, practice, and grow your skill set, too. Even as a couple therapist, I’m still learning how to better communicate with my husband and, honestly, I don’t think it’ll ever end. We’re both continuing to grow and change, and our communication needs to continue to evolve to reflect these changes. So, speaking from my own experience, busting out these basic communication tools sure does minimize the growing pains.
Allison Howe, LMHC
PACT Level 2 Therapist, PACT Ambassador
Couples come to our office in distress. They want to feel better. For me, PACT therapy provides medicine for the couple. PACT is an approach designed to alleviate the symptoms that come from an insecure, unfair, insensitive relationship that isn’t operating in a way that works for both partners.
If we define therapy as “medicine,” we need to understand its constitution. What are its active ingredients? How is dosage determined? What does an overdose look like?
Have you ever overdosed a couple? I have. I know what that looks like, and I now know to avoid it.
Therapy as Medicine
If medicine is “the science and art dealing with the maintenance of health and prevention, alleviation, or cure of disease” (Merriam-Webster.com), then to me, PACT therapy is medicine.
PACT has the potency – not as a chemical substance but as a medicinal approach – that restores and preserves the well-being of the couple relationship. PACT therapists help couples form a foundation with principles of fairness, justice, sensitivity, mutuality, and collaboration. As this process unfolds, the couple learns to depend on one another for survival, enabling both to thrive individually and collectively.
Therapist in the Medicine
If therapy is medicine for the couple, what goes into the medicine? From a psychobiological perspective, the therapist is a primary component of the medicine. My facial expressions (either under- or over-expressiveness), vocal tone, language, and body movement (either the openness or tenseness communicated via movement toward or away from one or both partners in session) impacts the couple.
Sometimes my belief in a couple’s capacity to improve is enough medicine to nudge them forward. Other times my deep concern for their future needs expression. While this therapeutic dosage can seem like a bitter pill to swallow, the communication leads them into a healthier direction. Videotaping my sessions has offered me additional information on how my facial expressions and body movements impact the couple.
If what I say and do in the session is a primary component of the medicine, I first must identify the substance to administer. (What is the intervention?) The next step is to be clear on the dosage. (How much?) In order for the medicine to be effective, the dose must have an opportunity to take effect. (How long between dosages?)
Signs of Overdose
When a couple does not respond to an intervention in a therapy session, they are saturated. That overdose risk becomes high once a therapist identifies the substance for the intervention, administers the dose, and then proceeds to introduce another intervention of some kind. The problem is that the therapist has no way of knowing which therapeutic action was effective or ineffective. I have done this, and I have seen a couple overdose as a result.
The goal is to help couples slow down from the impact of an overdose, so be aware of the signs. Speaking slowly or not at all, looking down (or up), nodding, drinking water to self-regulate all may be signs that the couple is struggling with too much stimuli. Many clients consider themselves compliant students of the process, and it can be shaming to acknowledge they feel lost.
Conversely, how do I know when the substance of an intervention is working?
- clear signs of relief
- ease of breath
- increased coregulation
- brightness in the eyes
Another positive sign is a subsequent behavior that aligns with the task – or medicine – of therapy, which is to improve the relationship.
Overdosing by Doing Too Much
More is not necessarily better when a PACT therapist is working psychobiologically. And, working slowly often works out better.
For example, doing too much can happen when we stage a conflict in the therapy session. The process of working sequentially to understand what happened and have each partner embody their part in the process takes time and attention. Couples can get diverted and introduce other issues.
As a result, I’ve learned the necessity of staying on track. Otherwise, the medicine will simply not work. “One thing at a time” is a good prescription to give couples when they are fighting at home as well.
In addition to the risk of overdosing a couple, we can’t be inspired when we are doing too much. Consider how we may be regulating our emotions through activity. The more we move and do, the less we observe.
Furthermore, we are less in touch with the interoceptive cues that can inform us of implicit content. I struggled with this issue in my development as a PACT therapist. During the session, I now scan my body for tension, focus externally, and shift my own body as a way to avoid falling into this trap.
Doing too much can also infantilize the couple. This is bad medicine. As the therapy progresses, we expect the couple will have their own ideas so they can move their relationship forward. If a therapist has a consistent stance of doing too much, the couple may not grow to believe they are capable of managing their relationship without the therapist’s support.
As a couple begins to operate securely, they will have less need for the medicine the therapist is providing. This is the implicit goal that therapists must make explicit.
Overdosing by Saying Too Much
If a therapist is doing too much, they are likely saying too much. When I’m saying too much, I’m unable to be present and focused on the couple. I miss signs of overdose along with other implicit and explicit material. Too many words can be difficult for a couple to absorb and understand, especially if they are already stressed.
A therapist can overdose a couple by saying a number of things at once, making it difficult if not impossible to know what the couple absorbed. And, if I say too much, I cannot be sure what was or wasn’t an effective therapeutic move.
What exactly did I administer in terms of substance? If I’m not able to answer that question, it sounds like an overdose.
Prescriptions and Regulations
When a couple begins therapy, the therapy can’t be the only medicine. In my experience, when couples practice what they learn in therapy (i.e., take their medicine), they become secure functioning sooner and more effectively. We can also prescribe rituals and practices designed around coregulation for couples to do at home. These practices create new neural pathways in each partner’s brain through an iterative process.
One of the reasons for longer sessions in PACT is to give the couple time to relax and prepare for reentry to their life outside of the therapy office. Have you ever asked a couple what they remember from a past session? Examining the memory system is like looking into a kaleidoscope. Take steps to reinforce the learning that occurred in the session. Have the couple briefly review key takeaways – what they learned or a new skill to practice. Keep what I call “competency cards” near their chairs so they can write their takeaways down if they choose.
You can titrate up a low dose of therapy, but a couple will have a harder time recovering from an overdose. “Wait, watch, and wonder” is an important approach we learn in PACT training. Consider waiting to gain more information before intervening. When we watch – talking less, learning more – we pay closer attention. As we wonder, we become inspired. And, to do that, we need to be focused on the couple.
Here are additional ways to avoid overdose:
- Write down what you are thinking as a way to self-regulate during the session.
- Move your body to change your own state. Make use of a rolling chair to change your perspective.
- Practice saying less.
- Still yourself. Slow down while partners absorb what is being said.
- Do not administer a medicine (intervention) unless you know the substance you are administering.
- Videotape your sessions, if possible.
- Remember your therapeutic stance: administer the medicine to the couple (a two-person intervention system), or support each partner as they administer the medicine to their partner (a cross-administration of intervention).
PACT therapy is medicine and can help couples get better and enjoy their lives. Like any other medicine, it requires thoughtful consideration throughout the process it’s being used. It’s a natural, holistic approach that couples are wired to provide to each other. Isn’t that the best medicine in the world?
By Jason Brand, LCSW
PACT Ambassador, Level 2
On a rainy Sunday afternoon in May, we wrapped up the Wired for Love Couples Retreat at Esalen in Big Sur, California. I assisted Stan Tatkin and Tracey Boldemann-Tatkin with 30 couples who came to find out how PACT can strengthen their relationship. This scenario illustrates how couples learn to shift their focus from self-protecting to strengthening their couple bubble. The couple bubble is a mutually constructed and maintained eco-system that provides protection from an often challenging outside world.
Friday Evening: Shelter from the Storm
After taking the winding turns of Highway 1 that opened onto the expanse of the Pacific Ocean, Annie and Sam put down their bags and went to Esalen’s natural hot springs. This was their first couples retreat and, on the drive, both admitted to being more than a little nervous. The baths relaxed their bodies. Their minds still raced with the stresses at home and work.
Once Annie and Sam entered the retreat room, it didn’t take long for a familiar pattern to emerge over a little thing with a long history. Annie did not like the seats Sam had chosen. They were going to be too far away to take part in the eventual action at the front of the room. She could have said something, but she worried Sam would accuse her “of turning everything into a big deal.” She settled into her seat, feeling resentful. Again.
Sam was trying to take care of Annie. She had often told him she wished he could be more assertive, so he took the lead and chose their seats. He even set down extra cushions, but Sam felt his usual shyness, a sense of letting Annie down, a lack of understanding how to make any of it better.
This silent bickering had been an annoying buzz in the background of their lives. Now that the PACT team was asking couples to slow down and hold each other’s gaze, they noticed the buzz was undeniably louder than either cared to admit.
The close proximity of the eye-gazing exercises on Friday night helped Annie and Sam see that if they were to going to make the world inside their couple bubble a safer place, they had to create a shared vision of how they would engage with the world. Their bubble had to allow Annie the stimulation to feel engaged and Sam the space to feel safe.
Saturday: Some Pain, Big Gain
As the details of the PACT model unfolded, Sam felt a comforting structure take shape. Sam liked structure, especially one that brought relief to arguments that never moved forward. Annie could sense Sam’s analytical mind engage with the information and loved how this allowed him to be more present in the exercises. It gave her hope that they could end the cycle of Sam needing to withdraw and her feeling like she was stuck with all the feelings.
Annie felt emboldened. They had both enjoyed talking to other couples over breakfast and engaging in the morning session. By lunch, things hit a snag. When Sam steered them to a quiet corner table, Annie followed but did not let it slide. She led with a compromise she knew Sam would reject. “We can sit here, but then we have to volunteer to do an exercise in front of the group this afternoon.”
Sam disagreed with a polarizing statement. “You just don’t get it. Sitting at a table for lunch is nothing like opening up our lives to a group of strangers.”
The next thing they knew, their argument began touching on their different approaches to parenting, sex, and money. They retreated to separate corners. The hope they felt that morning was slipping from their grasp.
While this did not feel good, they both noticed changes. The distress on the other person’s face registered with a new clarity. The hurt felt less like it belonged to one person and more like it hurt them as a couple. They both wanted to let go of the power struggle so they could return to how they felt minutes earlier.
The workshop leaders had talked that morning about the importance of quick repair. This was on Annie’s mind as lunch wound down. She did something she never would have thought to do before the retreat. She suggested they take a quiet walk to settle their nervous systems.
In speaking Sam’s language, she saw his face relax, the sparkle return to his eyes. On their way outside, Sam countered with his own bid by pulling Annie’s hand toward a couple from breakfast, suggesting they have dinner together. Annie could not help smiling.
Over lunch, Annie and Sam took the leap of faith they needed. Finding the couple bubble in times of distress requires risk; both partners willing to let go of deeply-held individual ways of seeing the world in order to see their partner’s perspective. In offering to walk, Annie showed Sam her willingness to look for value in a quiet approach. In reaching out to the other couple, Sam showed Annie his willingness to experiment with the limits of his internal comfort zone. From this shared place of greater vulnerability, they could open new possibilities as individuals and a couple.
Sunday: Taking It Home
The highlight on Sunday for Annie and Sam was how they cried together during an exercise, imagining their future. Each had shed tears of joy and frustration over the years, but crying together was something they had not done since the birth of their children. As they saw the tears in the other’s eyes and imagined what they would be like in 5, 10, 15 years, they felt the sweetness of all they had been through and the strength to face all that lay ahead.
As the weekend came to a close, Annie and Sam exchanged email addresses with new friends and gave the workshop leaders big hugs. They also agreed before they got into the car to flag anything that felt difficult and pull over to talk. That didn’t take long.
Sam remembered they had invited friends over that night and was excited to tell them about the retreat. Annie had forgotten the plan and was looking forward to a quiet evening. After pulling over so they could be fully attentive to each other, they argued for a moment and then laughed at their shifts in perspective. They agreed to ask their friends to leave early. Sam and Annie came home and greeted their kids with a new swagger. They looked and felt great, proud of themselves and their hard-earned sense of closeness.
One of my favorite parts about assisting at PACT retreats is noticing the way couples move toward each other as the weekend progresses. I see it in the focus of their eyes. They arrive with an external and self focus and, by the end of the retreat, they move toward a focus on the couple.
Of course, one retreat is not a cure-all for the challenges in a deeply committed relationship. Couples like Annie and Sam continue to have their struggles. What they experience at the Wired for Love Retreat is the practice of shifting the focus toward the couple. My hope is that they continue to build a sense of excitement and comfort from within their couple bubble.
Healing Trauma Relationally Through PACT
By Jeff Cohen, MFT
PACT Level III Therapist, PACT Ambassador
When Gayle and Paul came to see me, it was clear that Gayle felt Paul was the problem. Paul was taciturn to an unusual degree and could be quick to anger. For her part, Gayle presented as highly verbal, competent, and overtly friendly; adept at managing the tasks of their family and her career.
Though I didn’t know of Paul’s trauma when we first met — he lived in terror of upsetting a threatening stepmother and a physically punishing older brother — his manner and speech suggested that he moved through the world in a very protected stance.
It might have been easy to view Paul as the one who needed help. He was extremely literal, arguing about the minutia of his upset with Gayle, and for a long time was unable to understand the concept of providing relief first in an argument. From a PACT perspective, when a willing partner is able to help settle the distressed partner, it helps them both feel more settled and available to hear each other.
Looking in Both Directions
As PACT therapists, we look in both directions to assess a couple’s dynamic. Invariably, the couple alerts us to mirroring sensitivities and areas of injury. We see how primary partners are familiar to each other in recognizable and sometimes unconscious ways stemming from their own family histories.
As it turned out, Gayle had lived through her own family trauma. Her father was physically violent toward her mother and self-destructive. As the eldest child, Gayle become highly functional and competent in taking care of others. Indeed, her self worth was linked to that and to a belief that she needed to be perfect to be loved. Though Paul didn’t have a lot of ground to stand on from his angry and defensive stance, he was correct in pointing to a lack of openness and feeling he received from Gayle.
Initially we had to address Paul’s anger. To do so meant understanding the triggers which set him off so quickly. He was terrified of Gayle leaving him, so any comment along the lines of, “I can’t take this anymore,” would elicit that fear. Gayle’s comments were understandable in the context of their conflicts. As a PACT therapist, I also wanted to help her see how her comments threatened their relationship, so we experimented with other ways she could respond in those moments.
Practicing Neurobiological Responses
Gayle learned to set clear limits and be reassuring at the same time: “Stop! I’m scared when you yell. I’m right here. I’m not going anywhere, but I need you to talk more softly.” When this didn’t work, I asked her to simply sit down on the floor, to make herself small, which we experimented with first in the office.
PACT therapists will have couples act out situations to elicit the neurobiology of their actual responses. In this instance, to the surprise of them both, when Gayle sat down, Paul instantly settled down. Her sitting evoked his shame and guilt for how he was treating her.
We also worked with the internal wall which kept Paul safe and protected but also isolated. As he learned to identify when his wall was going up, I validated how well that wall had served him. “Your five-year-old self didn’t have anything else he could do. Thank goodness you found some way to protect yourself.”
Comments along these lines helped Paul feel compassion for what he had experienced. The acknowledgment allowed his softer side to emerge which, in turn, helped Gayle feel empathic toward him. This is the value of working with one person’s trauma in front of their partner.
Healing Trauma, Seeing Tenderness
“Can you look at her now?” I asked in one session when Paul felt his wall going up.
Since he was accustomed to seeing threat, I deliberately slowed the process down so he could take in what was happening. PACT therapists help couples see and read each other more accurately.
“Notice her eyes, what do you see?”
“Warmth, yeah, that’s right. And what does that warmth convey to you?”
“Caring,” he said. “Tenderness.”
“As you continue to look at her,” I instructed, “notice what happens inside of you as you feel her warmth and caring and tenderness.”
“It’s really hard,” he said, “I want to turn away and shut down.”
We had previously identified the shame he carried about being inadequate, how his anger and shame were intertwined, and how his defensiveness was partly a way to keep himself from having to feel that shame.
So now I reminded him, “Of course you want to turn away. It’s what you learned to do, but it also keeps you feeling alone. Young Paul didn’t have another option, but your adult self does. Let’s see if that younger you can watch as the grown-up you tries something different.”
Integrating the Experience
PACT therapists have couples face each other as a means of coregulating each other; doing so also helps keep them in present time, rather than fixating on negative memories. As Paul continued to look at Gayle and speak about his experience, I narrated what was happening, to help him integrate the experience.
“Notice what you’re doing,” I said. “You’re talking about how frightened you are without reacting to the fear by shutting down. You’re tracking your own experience while staying present with her, all at the same time.”
By slowing my pace and speaking gently, I was also eliciting his own mindfulness, which I knew would be settling and help promote new neural pathways to form around this experience of safety and connection.
“As you’re allowing yourself to be vulnerable now,” I asked, “do you think she likes this?”
This was not a hard question to answer. Gayle was doing her best to hold back tears, but I wanted Paul to register the impact he was having.
He nodded. “Yes, I think she’s very happy.”
Gayle reached out to hold his hands. “I feel so close to you when you let me see this part of you.”
“It’s new to me, too,” he joked.
“Yes, it is,” I affirmed before turning to Gayle. “Can you notice a difference in him?”
Changing the Couple Legacy
PACT therapists often ask questions of people about their partners to encourage them to track each other more carefully and to reveal both what they know and what they misread about each other.
In this case Gayle was right on. “He seems much more open.”
“I feel that, too,” Paul replied. “I feel more open and relaxed inside.”
Paul looked visibly different. “Because you’re more connected to yourself,” I said, “you’re able to feel more connected with Gayle. Can you feel how that is true?”
PACT is an experiential-based model of couples therapy, and I kept directing Paul back into his experience so he could verify for himself what I was observing.
“You’re also changing your legacy,” I said, wanting to underscore the importance of what was happening. “It wasn’t safe for you to go to anyone when you were young, but notice how available Gayle is when you allow yourself to be more open and vulnerable. Connection may not have been available to you then, but it is now.”
Seeing Paul take up his work made it safe for Gayle to do so as well. “I want more connection but I’m not sure I’m capable,” she admitted, beginning her own process of healing. Gayle was able to recognize that she also carried shame — remember, people are drawn to what is familiar — though she expressed it differently than Paul did.
As they learned to manage each other more effectively, in part by being more responsive to each other’s sensitivities, Paul also started thinking relationally, which was a paradigm shift for him. “I’m safer to her,” he observed one afternoon, “which allows her to show up more.”
Indeed. Partners do this for each other, and PACT is an approach which can teach them how.
By Susan Orenstein, Ph.D.
PACT Level 2 Therapist, PACT Ambassador
Let me start at the beginning of our love story.
My freshman year at Brown University, a resident counselor introduced me to another student because we both had a love of piano. Growing up, when I played for others, they would politely wait until I finished and offer a general compliment. But when the student to whom I had just been introduced heard me play, instead of general platitudes, he offered constructive feedback. I remember being thrown for a loop but also impressed that he truly listened and was authentic in telling me what he thought. Our basis for trust began right there. A few years later we began dating, and for his senior piano recital, we played a duet, Debussy’s “Petite Suite.” That student is now my husband.
Fast forward 30 years.
As new empty-nesters, my husband and I set off for Vermont to attend Kinhaven’s Adult Piano Workshop. The participants, all there to focus on four-hand repertoire, ranged in age from their 50s to 70s. We were greeted warmly by camp veterans, who had been attending this program for as long as 20 years.
My husband and I were initially intimidated by these musicians, talking in detail about piano scores and concert pianists we had never heard of. We tried to feel like we belonged, knowing we were in it together, and focused on doing our best to learn our duet for the student recital, held at the conclusion of the week.
The camp, located on the northeastern edge of the 400,000-acre Green Mountain National Forest, is rustic. We practiced in weathered cabins with rickety chairs, empty except for a magnificent Steinway piano taking center stage. In anticipating this week, we packed books and cued some movies, thinking we would have lots of leisure time.
We also searched online for things to do in Vermont, planning for some day trips. None of that happened. Instead we were joyfully immersed, practicing, side by side on small benches. The time flew by. Practicing together to get our piece up to par for the final recital took intense concentration, coordination, and teamwork. Here are some lessons we took home from the week’s experience.
1. Stay attuned.
Hear each other. It’s not enough to master your part. You need to listen for your partner. Understand the cues for starting and stopping together, for staying together. Look at each other. Breathe together. If your partner is rushing due to anxiety, connect with them to bring them back to the right tempo. Be in the moment.
As a couples therapist, I recognize that being in sync musically involves interpersonal regulation between two nervous systems. In drawing from PACT, the Psychobiological Approach to Couples Therapy, we pay a great deal of attention to each partner’s non-verbal cues, observing facial expressions, breathing, and posture.
We also watch to see how well couples are able to care for each other — some show an innate ability to comfort each other through humor, a gentle touch, or a soothing voice. Alternately, others become defensive or triggered by the other’s upset and unconsciously make matters worse through displays of subtle aggression or by shutting down.
2. Preparation is, forgive the pun, key.
Defining roles and making space for the other person is key to a healthy relationship. Although my husband and I enjoyed our practice time, we occasionally got frustrated when repeating the same mistakes.
At one point in the piece, I was supposed to place my left hand for one beat and then let go so my husband could play the same note with his right hand. I had gotten into the habit of holding the note too long. By not letting go in time, our fingers would clash. It became our inside joke, and it’s a funny memory (guess you had to be there).
To avoid getting in each other’s way on the keyboard, we needed to coordinate our moves and make sure we didn’t hold on too long. Being in a healthy relationship can often require letting go . . . of hurts, resentment, agendas, and, yes, sometimes keys on a piano.
In PACT, we help couples rehearse sticky situations and slow down the interaction so couples can practice new ways of relating that are more constructive. We help our couples think ahead of what challenges are on the horizon (e.g., a trip to visit the in-laws) and then stage a role-play, in which both partners can practice handling the situation with more ease and collaboration.
3. Let your partner shine.
Four-hand piano music is the most dazzling when the voices are highlighted at different times and in different ways. That makes the music nuanced and beautiful. To make that happen, one of us played the melody while the other played more quietly in a supportive, harmonious role.
As a couples therapist, I have witnessed the value of partners being present and caring during critical times of disappointment and loss. Yet, and the research bears this out (Journal of Personality and Social Psychology, November 2006), more important are partner responses to each other’s strivings and celebrations of success. Supporting your partner’s dreams and celebrating their time in the limelight are both crucial to being a great partner.
4. Coaching was illuminating.
Each day at piano camp, we had a coaching session from a master pianist. Our coaches listened to our piece, pointing out strengths and blind spots. They showed us specific techniques to bring out motifs and subtle sounds we would never have figured out on our own. We were grateful for the outside perspective – professionals who could take in the whole piece and help us integrate our parts.
As a couples therapist, I have a unique view of the couple. I am trained in both intrapersonal and interpersonal dynamics and can often see complex interplays that the couples themselves might not be aware of. That’s what makes my work so fascinating and also challenging. By being in the room with a couple, I can offer broad and specific feedback and point out blind spots that the couple has been too close to see themselves.
As my husband and I traveled home, we reminisced about piano camp. We reviewed the highlights of the week, critiqued the meals and lodging, and talked about who we wanted to stay in touch with in the coming year. We also discussed what pieces we’d like to learn and how to make time to practice before piano camp next summer. We returned feeling refreshed, accomplished and connected, now able to play our new piece – “Peer Gynt,” by the way, if you want to listen online.
By Stan Tatkin, PsyD, MFT
Two main issues face the PACT family therapy process: Structure and Attendance.
A challenge within typical family therapy is the structure that holds some family members to their particular family roles. While viewing members within the system frame is valuable, especially when it comes to various roles different members play, it can also restrict the flow of information as some members expand and express while others contract and remain in the background.
Using the PACT method to do family therapy may be more effective and convenient for both therapist and family. By dividing family members into pairs, the therapist can do “couple therapy” with various dyadic combinations, thereby freeing members from default role constraints and constrictions encountered when faced with the entire family system.
As long as invited members are of an appropriate age and maturity to participate in a couple-oriented approach, this structure:
- allows pairings to speak more freely about thoughts and feelings.
- breaks up alliances or substructures that exacerbate family conflict.
- increases intimacy between family members.
- opens more time and space for good work to be done.
Consider holding one or two sessions for at least two to three hours each per configuration to accomplish focused goals. The longer session serves a goal-driven purpose and can lead to satisfactory results for all involved.
Family therapy is typically organized by getting most or all family members in for at least one meeting, if not several subsequent sessions. The challenge facing therapists who use this format is legendary: how to get the same people to show up each time. Dyads solve the attendance problem as only two family members meet with the therapist at any given time – father and son, mother and daughter, sister and brother. Again, the only requirement is that children be mature enough to do “couple therapy” with an adult parent.
The dyad sit on moveable chairs and will spend a majority of session time face to face and eye to eye. However, the first-seating orientation is likely a V-formation with both individuals facing the therapist. This initial PACT session interview structure allows for a back-and-forth interaction between individual and therapist with cross-tracking, cross-questioning, and cross-interpreting. Specifying seating positions allows the therapist to get the lay of the land, so to speak, before putting the couple into the face-to-face position.
When the therapist obtains enough information to move into face-to-face positioning, individuals will then sit closely across from one another. The therapist will begin additional cross-questioning to test and retest early hunches, earlier flagged behaviors, responses, and interactions for further examination.
During this configuration, the therapist may choose to draw partners into an informal trance, the purpose of which is to slow partners down, focus their attention. Cultivating attention and presence ensures that partners keep eyes on each other while the therapist has them sit in silence for about ten minutes. This focusing exercise helps partners build vagal tone, an alert but relaxed state. Focusing and grounding partners in this way also builds a safe container, allowing more emotional “headroom” to tolerate difficult topics and painful admonitions.
Following the initial focusing phase, the therapist can move to difficult questions, bring up historical injuries for clarification and reconciliation, and help partners confront matters of deception, withholding of information, wrongdoing, and other unresolved issues in a safe container. Emphasis should be on truthfulness, clarity, and repair.
Mother and daughter come in after years of estrangement. The session length is four hours, sufficient time to reach the stated purpose for the session. Without unforeseen complications, and if done properly, they should not need a second session.
Mother has not been forthcoming about husband’s disappearance from their family home a decade ago. After 10-15 minutes of focusing the partners on each other’s eyes and tracking the moment-to-moment changes on each other’s faces, I ask my first question.
Therapist [to Mother]: As you look into your daughter’s eyes, tell her the truth about you and her father.
Daughter: (starts to cry)
Mother: (reaches out for Daughter’s hands) You were away at college. Your father was having an affair, or so I believed, and I kicked him out of the house. It turned out I was wrong this time, but only for this one instance. He cheated on me several times during our marriage. I couldn’t trust him.
Daughter: Why did you lie to me? Why didn’t you tell me the truth? You told me he left us for another family. He died a month later, and I never had a chance to speak with him again. How could you continue the lie even after his death? I thought he abandoned us. You turned me against him.
Mother: I know. (lowers her head)
Therapist [to both]: Just hold for a moment. Go back to staying in each other’s eyes. [Moments pass, then to Mother] Tell her why you lied to her and continued to lie.
Mother: I hated him, what he was doing to me and our marriage. I was terrified to tell you the truth.
Therapist: “Terrified.” Why terrified?
Mother: One or two of the affairs were with underage girls. (starts sobbing) Daughter: (face goes white, starts to say something)
Therapist [to Daughter]: Hold for just a moment. Just stay with your mother.
Several minutes go by before the mother recovers enough to speak.
Mother: I felt so ashamed. You knew one of the girls. I couldn’t tell you that your father was a sexual predator. I couldn’t. I know I hurt you. I lied to you and made you think that your father just abandoned you. I was confused. I was afraid maybe that he… maybe he…
Therapist: …molested your daughter?
Daughter: (with a soft voice) He did. Twice when I was about 12. I never told you. I never thought you would believe me.
Later in this session and in this face-to-face configuration, the therapist might install secure-functioning principles in order to midwife a reparative trajectory or pathway for moving the dyad forward into the future. Moving the couple into the future is also a device to fulfill their agreed upon therapeutic goals.
Therapist [to Mother]: Now as you realize the consequences of withholding the truth from each other, do you believe you both made the right decisions?
Mother: No. The secrets I kept led you away from me. You lost your father and then you lost me. I was wrong to keep this from you. And, I am so very sorry that I didn’t check with you earlier when I found out what your father was doing with underage children. That was horrible. I should have protected you. I should have made it okay for you to come to me.
Daughter: I blamed you for Dad leaving us. All that time I thought it was you. I didn’t tell you about what Dad did to me. I never thought I would. I wanted to think he was my only ally.
Therapist: Neither of you have been honest or forthcoming with the other. You both have been feeling alone, isolated, bound by secrecy and shame. Isn’t it about time for that to end? Your husband, your father, is no longer here. It’s just the two of you now. What will be the future of this relationship? What should the future be? What do you want it to be?
With partners still face to face in close proximity, the therapist can, and should, facilitate a process whereby both partners can forge a new relationship based on what they learn and want going forward. In this particular form of family therapy – though this example might seem complex for one session – the therapist acts as a consultant and facilitator with an agreed upon purpose and goal.
Each family dyadic combination requires a unique clarification of purpose, procedure, and goal for the session. Many variables exist. Suffice to say, each dyad has distinctive issues and concerns relating to history, age, and family role.
Dyadic sessions require a minimum of two to three hours. In general, I book three to four hours to get the job done. It’s not that future sessions are off the table. Rather, when using this modality, the therapist should be highly focused and time efficient so the “couple” finds clarity and relief as quickly as possible. If appropriate, the couple therapist should encourage ongoing individual therapy for both people.
As in all PACT therapy, the therapist is tasked with getting accurate detailed information from both individuals. Among methods for obtaining truthful information:
- disciplined testing and retesting of hunches
- finely-tuned monitoring of somatic reactions
- monitoring of collaborative and coherent speech
Only with accurate, detailed data that arises from each individual’s narratives, implicit and explicit behaviors, and partner reactions, can the therapist adequately formulate interventions and a treatment pathway for the dyad. Leading the session by following each partner step by step – remaining present to the interpersonal field and alert to the actual interactive sequence – helps mitigate therapist overreach, false assumptions, misappraisals, and personal bias.
Next time you are tasked with seeing a family or family members, consider forming various dyadic combinations instead of working with the family in its entirety. I think you will find this PACT approach more rewarding, more enlightening, and more effective.
By Debra Campbell, MS, LMFT
PACT Ambassador, Level 3
When a couple comes to our office, they bring a dynamic in the relationship that pains them. Neither partner sees the issue in the same way, and they don’t know how to solve it. Often, they’ve argued about it repeatedly. Talking about it just starts the argument again.
The rate at which the disagreement escalates is an indicator of how many times they’ve argued the same issue. We know they’re not dealing with anything new because the brain deals with novelty much more slowly than something we have habituated. How, as therapists, can we help the couple slow down and experience something new?
In PACT Couples Therapy, we use proximity, micro-expression, and body language to achieve more constructive outcomes that have a lasting effect outside of session. Here’s a familiar scenario:
Last fall, Rebecca and Bob were running late to their therapy session. They had struck a patch of bad weather, both literally and figuratively. These well-educated professionals have been married for about a year. By the time they arrive, Rebecca is in tears. Bob is red in the face.
I can cut the tension between them with a knife as we walk down the hall to my office. They each sit in a rolling chair. Bob crosses his arms and pushes away. Rebecca looks at me, grits her jaw, and fights tears. She declares, “This Kavanaugh trial is going to destroy our marriage!”
The U.S. Senate Judiciary Committee hearing had stirred up some old hurts as well as a historical style of arguing for them. My job is to slow them down so they can experience the argument differently. By doing this, they build new beliefs and gain skills that they can immediately implement outside the office to create safety in the relationship.
Prior to learning PACT, this situation would have been stressful as the therapist. Couples often come to session wanting the therapist to play referee or give solutions. With PACT, the direction is clear – they’re in each other’s care.
I instruct them to face each other, adjust their rolling chairs to eye level, and scoot into each other. They reluctantly agree and slowly move toward each other. Knee to knee, they’re two to three feet away from each other’s face. At this distance, the visual system has the highest acuity for every minute detail and movement on each other’s face.
Suddenly, the couple attunes to the present. Now we are dealing in real time with what is actually happening between them, not historical data or a pre-rehearsed argument. They are able to incorporate new information. When the micro-expression of their partner matches what is being said, a new reality sets in. The couple falls in love in each other’s eyes.
Couples misread each other. Instead, they tend to see what they have experienced in past relationships, generally with their family of origin. This contributes to overall misunderstandings and myths in the relationship. Rebecca and Bob are face to face, eye to eye, as I ask the following questions and check that they accurately read each other’s facial expressions:
Me: What do you seen on her face?
Bob: She is sad, but it is a manipulation. She always gets upset if I disagree with her. [He sighs.]
Me: Is he right?
Rebecca: I’m sad, but it isn’t because he disagrees with me, it’s because I was date raped in college and the trial has been very difficult to watch. Obviously, Kavanaugh is guilty, but he will likely get approved anyway because it is so hard to prove what happened, just like what happened to me in college. [more tears]
Me: What do you see on his face?
Rebecca: He looked angry, but less so now…something else, I can’t place it.
Me: Is she right?
Bob: Yes and no… I was angry before, but now I’m more hurt. I know that happened to her and I feel terrible about it. I would kill that guy if I ran into him. At the same time, I feel scared for all men if the judicial system can find someone guilty without proof. I want to protect her and myself at the same time but it seems impossible…
Me: Do you believe him?
Rebecca: [slowly] Usually not, but right now, yes.
Me: Where do you see it?
Rebecca: In his eyes. I can see he is scared but also that he cares about me. His shoulders are more relaxed, too. His arms aren’t crossed.
Couples often make the mistake of communicating without looking at each other – especially when things start to go sideways. The lack of facial cuing contributes to their misunderstandings.
Me: Do you guys usually have these conversations face to face?
Bob and Rebecca: [Both shake heads, indicating no.]
Rebecca: This argument just went down in the car.
Bob: We talk about this kind of stuff side by side while watching the news . . .
Rebecca: . . . or cleaning the house or cooking in the kitchen. . .
I suspect that they are misreading each other based upon their experiences from their families of origin. I want to expose that by testing their expertise on each other’s history.
Me: Did Bob have manipulative parents?
Rebecca: His father and mother are so manipulative to this day. I can completely understand why that would bother him, if he thought I were manipulating.
Me: Is she right?
Bob: Yes, my parents are manipulative. My relationship with them is strained.
Me: Does Rebecca manipulate you?
Bob: No . . . she really doesn’t. [His face relaxes.] She protects me.
Me: Did her parents protect her growing up?
Bob: Financially, they took care of her. She always had what she needed . . . went to a private school, etc.
Me: What about emotionally?
Bob: Well . . . no, I guess not. Her family doesn’t talk about personal stuff at all. I can understand how she might want that from me. I told you, honey, I would kill the guy who raped you if I could.
Rebecca leaves her chair to sit on Bob’s lap, curls into him, and cries as he holds her and rubs her back. When the crying calms, she resumes her seat. A spark renews in their eyes and a tangible feeling of connection.
Physical touch generally calms the nervous system faster and better than any other method of soothing. When couples can rely on each other for soothing, they become each other’s safe place. Couples that function securely can calm each other down using eye contact, proximity, tone of voice, body language, and physical touch. They act as an emotional resource to each other, a soft landing. Instead of relying on themselves to calm down or someone outside the partnership to soothe them, they rely upon each other. This interactive regulation is generally very healing when they have not received such emotional support in their families of origin.
PACT therapists assess a couple’s ability to accurately read each other’s facial expressions and body language. We do this by going granular. We ask questions about what their partner is feeling, where they see it, and checking with the partner to make sure they got it right. This is often where we expose new data:
- They don’t read each other’s faces accurately.
- They mistakenly apply historical data from their childhood relationships to their current relationship.
- They have never learned that you can tell when someone is telling the truth by their facial expression, tone, body language, and timing.
Instinctually, as therapists, we are trained to reflect whatever we see back to our clients. However, reflecting back that they have clearly had this argument before and that this is not new material does little in and of itself to change the dynamic. By putting them face to face, eye to eye, going slowly, and checking, we force them to address the reality in front of them. This present focus attunes them to live, novel data that creates an immediate shift in their affect and understanding. The truth lies in their facial expression, body language, tone of voice, and timing.
By Lisa Rabinowitz, LCPC
PACT Level II Therapist
In your romantic relationship, paying attention to your partner’s responses and attitudes is especially prudent. Observing impressions and reactions can help you become more in tune with a partner’s likes and dislikes. I refer to this practice as “obtaining your partner’s ‘owner manual.’”
For example, if I say the word rollercoaster, most people have a strong response, whether positive or negative. If I then plan a trip to an amusement park with my partner – and I love amusement parks – that’s great for me, but did I think about my partner and his reaction?
What if my partner hates amusement parks? The above example could be a win-lose situation if one of us likes rollercoasters and one of us does not. Pro-relationship couples promote win-win situations. Therefore, I need to know more detailed information about my partner to increase my chances of win-win opportunities with him.
Inevitably, your lives get busy. Time marches on. However, if you want your partner to feel important and loved, you must continue to update your knowledge and understanding of this person on a monthly, weekly, and daily basis. You need to be observant, like Sherlock Holmes. What makes her smile? What makes her feel sad? What triggers and irritates him? What brings him joy and happiness?
I’m not suggesting that you stalk your partner and start looking in his phone or following her when she leaves the house, but do you know what matters most to this person? In case you’re asking yourself, “Why does all this detail matter?” it does matter. When you know and understand your partner, then you can predict what may be perceived as threatening, which then creates insecurities.
In addition, you can learn the fastest ways to soothe and comfort your partner whenever he or she becomes hurt, which inevitably happens. I suggest when you notice X about your partner, you should be cautious and check in with a question, such as, “I think I noticed your face change to a sad expression. Did that just upset you?” Nonverbal cues, such as a change in facial expression, can help you better understand your partner and add new information to your partner’s “owner manual.” Here are a few scenarios to help illustrate why gathering this type of information about your partner is important.
Angie and Steve have been dating for a little over a year. Last week Steve stopped to buy her a hydrangea plant. Angie felt letdown as she wondered, “Why is he giving me blue hydrangeas when he knows I love yellow roses?” You might say, “It’s just flowers, so what? Why does that matter?” The reason it matters is because Angie wants to know she matters, just as your partner wants to know you are paying attention and noticing her likes and dislikes, interests, triggers, sensitivities, and what makes her tick.
Another example of paying attention to details happened to me last month. My husband said he really liked the chicken dish I made. How did I respond? I proceeded to make the same chicken dish every weekend that month! He had to politely let me know that, while it was delicious, he likes variety and asked if I could make a different chicken dish.
After our conversation, I realized that I should have known my husband likes variety. Even though I have eaten oatmeal for breakfast every day for the past 10 years (OK, a little exaggeration), he has a different type of breakfast almost every day. And, he regularly comments on my singular breakfast choice. How did I miss that?
Of course, you need to realize that you and your partner will make mistakes and overlook things that seem inconsequential. I share this example of paying attention to what my spouse said because as a committed partner, I want my husband to know I care about him, just as he shows me that he cares about me. Each of us can practice paying attention on a daily basis so we become more attuned to what matters to our spouses and more connected as couples.
In one of my sessions, Elizabeth and Rafael were discussing a conversation they had about going out of town so they could spend time together. Their lives were exceptionally busy, and Elizabeth kept saying, “Yes, we should go out of town, but now is not a good time.” Rafael was trying to reach out to his wife, but Elizabeth was not understanding his needs. In our conversation, I brought up information he had shared in a previous session. As a child, his parents were unavailable to him and would constantly cancel plans. As a result, he was sensitive to Elizabeth’s lack of commitment to spending time together.
Whether dating or married, every couple gets busy and caught up in their own lives. At times, one partner may even feel stuck doing all the listening without the equal opportunity of being heard. However, couples who understand and listen to each other’s needs and counter with solutions stay connected.
Elizabeth shared her concerns about the relationship, too. In the end, the couple worked out that, when Rafael asks her to spend time with him, Elizabeth could say, “I’d love to spend the weekend with you. Would X date work for you?” By giving her husband a specific date, he felt that she was making him and the relationship a priority, healing old hurts and pain from his childhood. The couple made a date – just the two of them – for 3 months from our appointment. We discussed how to be understanding of individual schedules and, on balance, the need to make time for each other.
- Slow down and focus on your partner’s feelings and reactions to situations.
- Take note: if you are talking about X and your partner turns away or looks down, check to see if he is upset or if something is bothering him.
- Create win-win situations by thinking about your partner.
As partners, it’s essential for us to have our partner’s owner manual. When we don’t, we risk being seen as threatening or not loving our spouse. Frequently, partners end relationships because one partner didn’t know what really mattered to the other. If you begin to hear statements such as, “You just don’t know me,” “You don’t get me,” “You don’t seem to really care about me,” take action. Find a reputable PACT therapist in your area to help you “know each other,” reduce insecurities and increase your connection. When you take the time to obtain your partner’s owner manual, you begin communicating “I want to understand you,” which will improve the likelihood of a secure relationship.
Tatkin, Stan. (2016). Wired for dating: How understanding neurobiology and attachment style
can help you find your ideal mate (p. 31). Oakland, CA: New Harbinger Publications, Inc.
Tatkin, Stan. (2018). We do: Saying yes to a relationship of depth, true connection, and enduring
love. Boulder, CO: Sounds True.
By Lindsey Walker, LMFT
PACT Ambassador and Level II Therapist
Couples therapists often struggle with how to sort through the many feelings and complicated relational dynamics that arise in couple therapy sessions. You have two people, both hurt. Each come with a different perspective, combined with years of history and unresolved conflicts, and they are looking to you to figure it all out.
By walking into your office, they invite you into their relationship. As a therapist, you join them through attunement. As a PACT therapist, you combine your attunement with identifying the couple’s observable behavior, which enables you to determine what they have not yet integrated into a secure-functioning relationship.
When you mind your own experience with couples, while simultaneously observing how they interact with each other, they provide you with real-time information about who they are and how they handle their relationship. As you gain this information, you can feed it back to them. This helps them build an understanding of how they are functioning. It also creates opportunities for them to move away from destructive dynamics.
In one session, Rochelle and Brandon sit as far back in their seats as possible, leaning away from one another without trying to be obvious. A line of tension runs through their bodies, which tells me they are not fully relaxed.
I look at one member of the couple and see her folding in on herself, hands tucked under her legs, which are crossed. She bites her lower lip. Her partner’s body twists toward her. However, his neck cranes to look at me whenever discussing his feelings or experience.
I take these observations in and then turn my focus inward to take note of my own senses. Am I feeling something strongly? Seeing any notable pictures in my mind’s eye? How’s my body handling the stress of the situation? What ideas are coming to mind? Is there something I’m moved to say here? How pressing is it? My breath is shallow. I feel tension in the room and also inside of me. Most notably, I feel stuck — if someone asked me to speak, it would seem impossible.
As therapists, through our attunement, we experience the relational wounds that our couples bring to us. This body-to-body exchange of information is communicated so quickly. Couples often miss it, which is why they end up in therapy, stuck in repetitive cycles.
In the example of Rochelle and Brandon, when I look inward, I get information about what it feels like to be with them, which the couple needs for themselves. Closeness is difficult for them. Internally, I interpret their body postures combined with historical information I have gathered about them: they deal with the tension of intimacy by either turning inward (Rochelle), or toward something or someone else (Brandon). Speaking openly about their more vulnerable experiences is not something they know how to do.
From the neck down, Brandon shows me that he wants to be with his partner. From the neck up, however, his eyes plead with me, asking to know whether or not he’s safe to turn all the way toward Rochelle. I feel a great sadness well up in me.
I feel that these two are mourning the loss of closeness in their relationship, and they don’t yet know how to connect over it. When they are not in the therapy room, they resort to old patterns of attack/defend in the face of vulnerability. As a result of not knowing how to express his more vulnerable self safely, Brandon gives his sadness to me, instead of to Rochelle. Though she is facing him, Rochelle does not signal to him (or to me) that she is ready for what he has to offer. She is too preoccupied with managing her own anxiety.
My purpose in their relationship in this moment is to contain the experiences that they are not yet equipped to handle within themselves or their relationship. I recognize this via my own felt experience, what I see in them, and how Brandon is interacting with me. I prepare to help move them toward each other.
Brandon starts to talk to me. I want him to know that what he is saying is valuable, so I focus my attention on him. This kind of affirmation can serve as a bridge for him to contain his own experience within their relationship. Yet, the goal of couple’s work is to help them find affirmation and support within the couple system. Knowing this, I want to turn them back toward one another to see how they handle each other in this vulnerable moment.
Now a therapist can take many directions, all lead to the same essential thing. Here are several possibilities, including the PACT methods of cross-questioning, cross-commenting, or going down the middle:
- To her: “Does he always look away from you when he’s feeling vulnerable?”
- To her: “He’s about to tell me something important, and I don’t want you to miss it. What happens when you ask him to look at you?”
- To him: “There’s something you want to tell her, but you feel more comfortable telling me. Why?”
- To him: “Experiment with turning your head to face her. Look her in the eye, and tell her what you just told me.”
- To both of them: “You want to be close, but it’s hard for you to fully let go.”
- To both of them: “It’s hard to speak about how you feel with one another.”
- To both of them: “You guys are so sad together, but you don’t know how to share it.”
With these interventions, you’ve taken what you discovered about them and used it to highlight how they operate with one another. This helps them:
- Identify a feeling they have so they can begin to integrate it into their couple system.
- Increase awareness of how they react to one another in tense situations.
- Own the idea that there is something they want together (though in some cases, not) and for which they are both responsible.
Couples therapy moves fast. Your couples signal to you all the time about their distresses, their hopes, their worries, the ghosts from the past that they struggle with. Your ability to be pulled into their system, and yet retain the sense of your own experience and observational abilities while in it, is one of the best tools you can use to help them heal their relationship.