As such, I believe it is essential our clients are consciously aware of those insecurities and the behaviour they drive.  Failure to get clients to make that connection leaves them looking in the wrong places for solutions – either blaming their partner or collapsing into shame and self-blame – neither of which will solve their relationship issues.

Since writing that blog, I have had many conversations with colleagues discussing how hard it is to accurately identify core insecurities, especially when clients are reluctant to accept the impact of their upbringing on their present-day behaviour.  Where their answers to my final four questions in the previous blog are superficial or dismissive. Many clients seem offended or contemptuous if you suggest they are still being affected by less-than-ideal circumstances in their childhood (probably as sign they feel ashamed or exposed by your suggestion). 

Their tone and manner suggests they regard still being under the influence of childhood events as a moral failing rather than an inevitable truth of the human condition.  Ironically, this is often a reflection of, or result of, the kinds of core insecurities their upbringing created. The strong emotional reaction they are having is probably rooted in exactly the shame that you are trying to get them to track (and that is causing difficulty in their relationships). There is often also a sense that being open to the idea that their childhood was anything less than “fine”, “normal” or “good” is being unappreciative and disloyal to their parents or family.

Reflecting on those conversations, I realised I have a four-pronged approach to clients like this

• Psychoeducation about the neuroscience of the developing brain (esp pre-adolescence), emphasising how self-centred kid’s minds are because of their cognitive limitations
• Exploration of their childhood with me highlighting how seemingly unimportant or “normal” events might have had more impact than they realise.  Showing them how the theoretical concepts I have discussed in #1 might have played out in practice in their life.  Sometimes this is done in the face of great scepticism from clients (often hiding their fear of exposure).  But I am setting the scene for…
• Stressing the reflexive ways they are protecting themselves in the present (ineffective self-protective behaviour) and demonstrating how those behaviours were adaptive in the context of their upbringing but are damaging to their current relationship(s).
• Accompanying this all the way through is an emphasis on self-compassion.  Clients need to understand that, while they are responsible for their behaviour as adults, they were NOT responsible for the events that shaped them in childhood.  That when we recognise that we are reflexively doing unhelpful things, the useful response is to be kind to ourselves and try and attend with love to the parts of ourselves that are still hurting because of what we came to fear all those decades ago.

I think the key is persisting in showing them how this way of understanding themselves opens up new possibilities for changing things.  How being vulnerable instead of shut down draws their partner closer.  How being assertive instead of appeasing allows their partner to become more attuned to them.

Many people will not easily follow your lead – you will have to be tenacious and back your knowledge and experience.  A lot of clients equate self-compassion with self-indulgence and vulnerability with weakness.  Others have been trained to blame themselves and take responsibility for things that are not their fault.  Those clients need help in understanding where they learned such unkind and self-destructive beliefs.  It’s vital that we don’t let those beliefs stand unchallenged in our therapy. 

It is a situation where we need to lead, not follow, our clients.  To have the confidence that, in this respect, we therapists see more broadly and deeply than they do, because their core insecurities blind them to seeing their true worth. Hence, our perspective is much more likely to give them hope and a path towards achieving the intimate relationship they crave.

Before employing this tool, you may need to reflect on whether it’s okay for you to make your clients uncomfortable.   Some clients find an exercise like this very exposing.  It gives you invaluable information about the way they operate in a very short space of time, so it’s in your client’s interest – it will save them time and money.  However, the therapist has to have a level of Differentiation to tolerate their discomfort with being asked to expose themselves in this way.  Make sure you get their consent to experiment with something different.

It’s a good idea when you do this exercise to warn people that you are going to be giving them some specific instructions and then you’re NOT going to explain any more, so they need to listen carefully.  In the beginning, to help you analyse the exercise, you might want to record the conversation (with your client’s permission).  Makes for great reflection in supervision!

The format

Taking a blank piece of A4 paper you turn to one person, hold up the piece of paper, look them in the eyes and say “This piece of paper represents something important to you. I’d like you to take a minute and think about what this piece of paper represents to you. You can pick anything that’s important to you except for your kids and your relationship.”  That is, you are asking them to imagine that the piece of paper IS the important issue.

Then pause and keep looking at them to give them a moment to process and take in your request.  You can ask “Have you got something?” or “Can you think of something like that?”.  When they have thought of something then you turn to their partner and repeat the exact same process with the exact same words.

Once they both have thought of something that the paper can represent that is important to them, then you ask each of them to hold onto one end of the piece of paper and say  “I’d like you to hold this paper between you and I’m going to give you up to five minutes to decide who gets this paper without ripping or tearing it. You can do it verbally or non-verbally. You can do it any way you like, but at the end of the five minutes, I’d like you to decide who gets the paper without ripping or tearing it.” It’s important to note there is nothing in these instructions preventing people from saying what they want and why.

I will usually also add that I’m going to give them a one minute warning before the five minutes is up and repeat that I’m not going to give them any further instructions or answer questions, that I want to see how they deal with the situation I have set up for them without me interfering further. 

Some people will really try and engage you with questions because you’ve created a projective type of situation that’s unsettling for them and they’re going to want you to structure it for them.  It will undermine the value of the exercise if you give in to the pressure of their anxiety. I keep saying back to them, “You can do it any way you choose and you have up to five minutes to decide who gets the paper without ripping or tearing it.”

Then you sit back and watch what they do.  You can literally move your chair back to indicate they are on their own with this.

After the 5 minutes is up make sure you thank them and give them positive feedback about doing the exercise. Ask them how they are feeling having done it.   It’s always good to ask them if what happened is typical of how they deal with conflict at home.  If it’s not typical, then explore why they behaved differently in this session than they usually do.

The asessment

You will get very different behaviour depending on the developmental level of the couple.  With some very symbiotic people, this is a very quick exercise because they are so panicked at the thought of a conflict one of them immediately gives the other the paper, without any discussion. 

Below are 6 questions you can ask yourself about what your clients did.  Each question points to a different aspect of the developmental stages.

1. Do the partners self-define?

The first thing is are they able to say what they want?   Very Symbiotic people won’t say or be really vague about what the paper represents to them.  Expect Symbiotic clients to blame you when you point out they didn’t say what they wanted – they will say you implied they shouldn’t say what they wanted (this is part of why sticking to the carefully ambiguous script when introducing the exercise is so important). Others will be very defensive or apologetic about saying what the paper represents.

• How do they manage boundaries? Are their boundaries rigid or overly permeable?

Once someone defines themselves by saying what they want, what happens?  Do they rigidly defend or collapse & give up easily??  Do they merge (I change what I want to join with what my partner selected)?  Do they look angry or upset that their partner wants something different from them?  It tells us about the level of Differentiation and also will be congruent with the Attachment Style.

• Do they show awareness that their partner is separate and different from them?

Shown in asking a lot of questions about what the other person picked – why is that important to you? Why does that matter to you?  If you took it could I ever share it back? Those who don’t engage at all tend not to have much awareness that the partner is separate and different from them

• How do they manage conflict? Is it avoided, escalated or acknowledged and handled?

If one collapses and the other accepts this then they’re both avoiding the conflict.  If they do have the conflict,  how  do they have it.  What is the emotional tone of the conversation – can they stay open, friendly and collaborative or does the presence of conflict make one or both of them closed, hostile, anxious etc?  Are they willing to hang in there even though the time is nearly up or do they foreclose on the conflict. A lot of people who are quite solid in their development won’t be able to resolve the conflict in 5 minutes and this is an indication that they are able to tolerate conflict productively and manage their anxieties.

• Do they have the capacity to move the conflict forward?

If they avoid it you won’t see this but if they are at the rapprochement stage you would expect them to be exploring options to see if there is a way they can resolve this without either of them giving up what they want.  As a rule of thumb, the more developed, the more creative and collaborative they’ll be in their exporation of potential solutions.

• Is each partner able to give and/or receive?

Interestingly people who are in the Rapprochement or Synergy stages are likely to end up doing something that Symbiotic people do, with one of them giving up the paper for the other.  However the pacing, tone and meaning of this is VERY different. It’s not done quickly to avoid anxiety, but after lengthy discussion where one of them decides “Hearing what it means to you I’m happy for you to have it”.

It’s a matter of clinical judgement how much of what you observe you feed back to your clients and when.  This exercise can be a good opportunity to explain the notion of Developmental Stages and indicate to each of them where you think they are at and what the developmental tasks are they have in front of them.

Clients will choose to make themselves vulnerable if they believe that the rewards are worth it. Emotional vulnerability is an essential part of intimacy and feeling truly loved. Everyone has ways to reflexively protect themselves from emotional hurt. For example, your client might be smiley and pleasing (so they don’t offer any threat), or they might be stony-faced and grumpy (so they look tough and dangerous). They are hiding their deeper thoughts, feelings and desires from view so that people can’t use those thoughts, feelings or desires to manipulate or hurt them. They feel vulnerable, so they act defensively.

Remember, the more important someone is to you, the easier it is for you to feel hurt by them. When a stranger ignores, rejects or attacks you, that’s bad enough; but when an Attachment figure does, the pain is so much worse. That pain causes your amygdala to see your loved one as a threat. In a committed relationship, you organise your life around an Attachment figure. A rupture in that relationship threatens not just your feelings but also your living arrangements, your financial security, and your connection with your children (if you have them).

So, when their partner is upset, insincere, grumpy or withdrawn, your client may feel very vulnerable to hurt. Their instinctive response is to protect themselves. But when your client puts up their walls and acts defensively in turn, this is an ineffective way to try to care for themselves. It destabilises the Attachment relationship, making them more open to significant hurt in the long run.

To maintain their connection, they must accept their vulnerability to their significant other rather than fight it. Being vulnerable is part of acting with integrity. Consciously sharing what’s happening inside you does give their partner information they could use to hurt them. It’s a risk. But they are far better to take that risk and find out whether their partner can meet them, as well as whether they can look after themselves when their partner is unavailable.

Being vulnerable requires being Differentiated — knowing and showing how it is for you at the same time as being accepting of and interested in how it is for your partner. Being vulnerable also requires effective management of your neurobiology, i.e. good self-regulation. Your client’s impulse to protect themselves will arise and require managing. Remember, tolerating vulnerability is a hallmark of those who are Securely Attached. If they’re just ‘acting Secure’, then learning how to be vulnerable, rather than focusing on the anxiety of how vulnerable they feel, is a crucial component. The script below offers your clients a structured pathway to being vulnerable with their partner. Feel free to use it in your practice.

Here is a step-by-step guide for how to respond when you feel vulnerable or hurt.

I feel VULNERABLE
(maybe because I have been hurt)

↓

Triggers reflexive impulse to self-protect or act out, distract, feel numb, etc.

↓

Recognise the impulse for what it is, allow self to feel the VULNERABILITY and don’t let yourself act impulsively

↓

Go slow and self-soothe — attend to VULNERABLE or hurt feelings (including reaching out to friends and other supports)

↓

Organise your thinking — maybe write some notes, or practise talking out loud to yourself or a friend, so that you have clear, non-judgemental language to describe what’s going on for you

↓

Be VULNERABLE
Open up to partner about the original VULNERABLE or hurt feelings (use non-blaming descriptions)

↓

Compassionately explore and discuss the VULNERABILITY, focusing on meanings you make, your interpretations and insecurities (not the same as justifying self-protective behaviour)

↓

Be sure to talk about how much VULNERABILITY and hurt is from your upbringing rather than focusing on what your partner did

»»»

Having a person like this as your client can be challenging. Enquiries about their emotions or the meanings they make of events are often met with an “I don’t know” response. Many of us were trained never to lead clients. If we are rigid about this it can leave us with few options at this point. However, there is a real danger in the client remaining unseen and unheard. If you are doing couple therapy there is also the danger of partners losing hope “See, even our therapist can’t get anything out of you!”

If you suspect your client DOES know but isn’t saying you can enquire about that. You can ask “Is that an “I know but it’s too scary to tell you” type of “I don’t know” or an “I have no idea how to process what you are asking me” type of “I don’t know”?”. If the answer is “too scary” then that opens up an avenue of exploring what are the feared outcomes of answering the question.

If the person doesn’t know how to process the question, consider what you know from their history about how likely they were to have been taught or have modelled for them how to think about nor talk about their emotions and internal experience. In most cases, they haven’t had the training, and so our role becomes to scaffold them up to the kind of emotional literacy needed to maintain an intimate adult relationship.

In a sense, our role becomes one of re-parenting. It requires patience and compassion from the therapist. It is so easy for these men to feel inadequate and ashamed. In many cases, they have had years of partners expressing frustration at their inability to be open and articulate. Therapy is a very scary and hostile environment for them and it is our professional responsibility not to add to the emotional burden they carry.

One tool to use is to use the Feelings Wheel – I focus on the 6 core emotions in the centre. Although I acknowledge that there is a downside to labelling emotions as positive or negative (all feelings carry useful information), at this level of education I find it valuable. In response to an “I don’t know how I feel” I ask, “Well, do you feel negative or positive?” Most people can answer this kind of simple binary question. Armed with this knowledge I get out the Feeling Wheel. Using the wheel they then only have to choose between 3 options. If they say it’s a negative feeling – is it Sad, Mad (angry) or Scared? If it’s a positive feeling, is it Peaceful, Powerful or Joyful? If they want to, they can then look further out on the wheel to refine their language. Breaking the question down into these three steps makes it less overwhelming. This is something that they can then use with their partners at home.

In other situations I won’t use the wheel, instead, I will offer them options of feeling words based on A) my knowledge of them and B) on my experience of others and C) my own life experience. In response to the “I don’t know” I will say something like – “In my experience, people in a situation like this might feel angry or hurt or overwhelmed” OR “If I was in your shoes I think I would feel anxious or unimportant or maybe angry” and then continue with “Do you think one or more of those feelings might be going on for you?”. If your client is not completely blank, you also have the option to say – “To me, you look like you are irritated or frustrated – would that be about right?

Using these kinds of strategies repeatedly I find that, over time, many clients become more self-aware and articulate. If they can do it in the therapy room, their partners begin to realise they can also expect it at home. There may need to be some discussion about inviting openness, rather than demanding on it (see the discussion of shame and inadequacy above).

Yes, talking in this way leads the client, and we need to be very cautious of clients saying something just to please the therapist. If we choose to guess, we also need to be attuned to subtle signals that our guesses are wrong. However, I would argue that the potential benefits to clients who are inarticulate in this way (and to their partners) outweigh the risk.

The secong of these stages is “Differentiating” and this is the place that so many of our clients are stuck at.  They cling on, unconsciously but desperately, to the fantasy of fusion, of “the two becoming one”, and don’t develop the skills necessary to deal with differences and the conflict that differences inevitably implies.

Differentiating means being aware of, and able to express, my inner thoughts and feelings in a way that it is considerate of who my partner is and where they are at in this moment.  Being able to be true to myself AND, at the same time, showing interest in and care for who and how my partner is.

This is care for the other is what makes Differentiating quite a different process from the more familiar individual developmental issue of Individuation.  Learning who you are and how to express it and assert it is only HALF the picture when it comes to relationships.

The ability to manage the anxiety that is inevitably raised by conflict, by being aware of our differences, is crucial.  Helping our clients understand that, regardless of how upset they feel, they are still responsible for their own behaviour is a key part of helping them learn to differentiate.

We don’t learn how to do this all at once.  There is a typical path that we tend to follow as we develop our ability to differentiate.  This can be broken into 5 phases:

1. Developing the ability to self-reflect; to notice and accept our own thoughts, feelings, wants and desires.
2. Developing the ability to express those thoughts, feelings, wants and desires.  This requires tolerating the risk involved in exposing “who I (really) am”.
3. Developing awareness of my partner as separate and different.  Often initially I may respond to this as a threat.  For example, I see your different opinion as a criticism of me, or you wanting something different meaning I will miss out etc.
4. Developing an increasing ability to listen, hear & respond to differences.  Exploring the differences with curiosity and openness and clear boundaries – caring about you AND myself.
5. Developing the ability to create an environment in the relationship that supports desired changes.  Negotiating in good faith, being able to compromise on an issue without compromising my selfhood, knowing when I can afford to be generous and when I can’t, being creative in finding solutions rather than sticking to first positions etc. etc.

Recognising where each of your clients at in their ability to perform these key developmental tasks is a great way to make our work more incisive and efficient

Experienced couple therapists know that “communication problems” are almost never the real problem.  Formulating within the Developmental Model allows us to identify where each partner is held up in their relational development.  People who say “we can’t communicate” are often holding onto lifelong symbiotic fantasies or, at best, are at the early stages of differentiation and dealing with difference inexpertly.  Such couples often want closeness without really doing the work of tolerating the emotional vulnerability necessary for intimacy.

The impasse can often show up in one of four ways is:

• an inability to be accountable
• self-protective reactivity
• lack of motivation
• lack of ownership over regressive responses.  

If a couple is severely stuck, all four forms can be present.  Partners will use strategies such as blame, resentful compliance, confusion, a “poor me”/victim stance or withdrawal as ways to cope. 

Our role as therapists is to support the growth of the emotional capacities required to feel more internally solid so partners can show up as they truly are rather than ineffectively defending themselves or denying their inner states and pointing the finger at their partner.

Picture a couple where one partner held the hope (symbiotic fantasy) that her mate would notice her, read her distress and provide her with the comfort and care she craved after a hard day at work, without her ever having to say a word.  So at the end of each day she would wait in silent expectation, and when he inevitably failed to read her mind, she would withdraw emotionally and physically, feeling hurt, disappointed and self-righteously resentful.  Now imagine how this behaviour impacts on her partner – he feels confused, anxious and hurt.  Typically, he is no more differentiated than she is, so he inevitably believes that she intends to make him feel that way (another symbiotic assumption) and, rather than talking about it, withdraws into a self-righteously resentful sulk of his own.  It doesn’t take very many iterations of this cycle for the atmosphere in the home to feel very heavy and unpleasant. 

When working with a couple like this our role is to help each partner take individual responsibility for their part in the cycle.  The DM offers us great ways to do this by naming the pattern we see that is not working, catching those pivotal moments when defences surface, holding each partner accountable and creating a boundary around each individual while still staying connected to their partner.  This allows for the beginnings of differentiation to surface as two defined individuals now exist within a relationship rather than one fused relational entity.

However, a word of warning.  Developmental growth is anxiety-provoking, especially when it comes after a period of developmental stagnation (e.g. staying stuck in Symbiosis for 10 or even 20 years).  So, when supporting partners to move forward they are likely to become triggered and their defensive patterns will emerge and can be turned towards us as therapists.  Questions such as “why are you picking on me?”, “what about him/her?”, “why is it always my fault?” can come firing our direction.

When clients react this way, they can appeal to our own areas of vulnerability such as our fear of conflict, desire to be empathic, fear of being a bad therapist (imposter syndrome).  To remain therapeutic we need to use our own differentiation skills and lean into our belief In our goodwill and our expertise, staying true to our assessment and judgement (while still being open to client feedback). 

For example, if you coached this woman in the case above to talk about the vulnerable feelings underlying her hostility and, further, to take responsibility for how her silent response impacted on her mate and apologize to him, she may be quite challenged at first.  But if you persisted and she spoke vulnerability about her hunger for connection at the end of a workday, it is likely that she (and we) would see a very different response from her partner – one of concern and care, one that precisely meets the needs she has been so inexpert at communicating.

Ellyn Bader emphasizes the importance of slowing down at these pivotal moments of vulnerability.  Vulnerability makes people uncomfortable and they will need guidance to stay in the moment and savour these new ways of interacting.  Ellyn encourages us as therapists to make room for non-verbal empathy behaviours to enable deeper connection suggesting therapists try things like

• telling couples to slow down their verbal responses (the importance of silence)
• encouraging deep breathing
• modulating to a gentle tone
• inviting the couple to hold eye gaze

Ellyn highlights that there is a typical sequence in which partners find ways to hide from their vulnerabilities and that we can successfully intervene to transform these stuck patterns.  Our role as DM therapists is to:

• Describe non-judgementally what we are seeing each person do in their personalized flight/fight/freeze self-protective strategies
• Connect the dysfunctional “communication patterns” with early coping learnings
• Assist each partner to “own” (take responsibility for) their contribution to the impasse
• Structure change in the here and now by experimenting and offering positive encouragement and support in sessions
• Follow-up next session to see if they were able to maintain their new behaviours
• Check that they feel understood and that they understand their partners more deeply
• Highlight the relief this creates relief and
• Reassure them that new neural pathways will be forming to enable healthier relating to resolve those “communication” problems

When we can accomplish these tasks for clients then we can be confident we know what to SAY and DO when clients present with “communication problems”.

Paula Dennan

Yet our culture idealises the notion of needing your partner. “I need you” is generally offered up in a movie or book as the ultimate declaration of love, the height of romance.  We are encouraged to give ourselves up or surrender to our partner.

So why is it that so many people complain about it??

When we give ourselves up or surrender to our partner, we are making our identity dependent upon the choices and behaviour of another person. If this is your model for love, this can eventually leave you feeling trapped in a very vulnerable and dis-empowered position.

The answer to understanding how we fall into this trap lies in understanding adult development, particularly the development that takes place in the context of relationships.

The state of passionate merger that is idealised in books & movies is only the first of many stages that a relationship can mature through over time. Colloquially it’s called the “honeymoon” phase (although it’s often over well before any commitment rituals are planned). Typically it lasts between 6 months to 2 years.

In the Developmental Model we formally label this stage “Symbiosis” and define it as “…a merging or lives, personalities, and intense bonding between the two lovers.  … similarities are magnified and differences are overlooked” (Bader & Pearson 1988, p.9) . This rush towards sameness provides comforting evidence of the bond.  However this can create a false sense of security as, eventually, differences surface and need to be dealt with.

If a client is stuck in this stage they may be saying to (or hearing from) their partner things like: “I NEED you be with me/ have sex with me/tell me what’s going on with you/share my hobby/ etc”. The difference between “wanting” and “needing” gets lost in this way of talking.

Here’s how we think the two differ:

The difference between “need” & “want”

You are welcome to use this table with clients (appropriately credited to this webpage, please) as you try and help them see that owning their wants and desires is a healthy step in self-definition and clear communication, both of which will enhance their relationships.

Nic Beets

…I learned about the Couples Conference, and attended the 2015 Conference earlier this year.  This conference has over the years pulled together many of the leaders in the field of couple therapy including Harville Hendrix, John Gottman, Pete Pearson, Ellyn Bader, Wiliam Doherty, Bill O’hanlon, Ester Perel, Stan Tatkin,  Pat Love, Jeffery Zeig, Marty Klein and the list goes on.   Hosted by the Milton Erickson Foundation, the very spirit of the conference is one where different perspectives are respected so that the commonalities that underlie successful clinical work can be shared.  It is a great environment to learn from, to explore and debate the differences too.   The next conference is being held May 13-15 2016, in San Francisco and themed on the topic dear to my heart : Attachment,  Differentiation and Neuroscience in Couple Therapy.

If you can’t imagine going but would be interested in exploring what is said at something like this, the Erickson Foundation website has audio recordings of many years of presentations available here:

I am also keen to hear how you continue to develop your craft as a relationship therapist.  Do you stay true to one school of therapy and dig deeper through conferences and publications?  Do you “shop round” randomly as topics or presentations are advertised?  Do you plan your year in advance considering the problem areas of couple/relationship work that you want to improve? Perhaps you have found a system of doing this that can be shared with others.  I would love to hear about it so leave us a message in the comments box below

Paula Dennan

This kind of scenario puts a lot of people off working with couples. And those fears are not groundless. If you work with couples, it’s only a matter of time before you will encounter people like this. These couples can evoke many feelings in us as therapists – fear, dismay, frustration, helplessness and incompetence to name a few. They certainly are the couples feel like steering clear of.

But it’s not all bad news – there are ways you can feel productive and competent with couples like this. In this blog we’re going to use a case to give you a taste of how the Developmental Model provides a secure framework to make sense of and work with people like this. These cases are complex – so it’s a longer blog than usual.

The Case of Jane and Paul

Jane and Paul had a complex history of loss and trauma in their long term relationship of 20 years. They had “survived” many psychosocial stressors (including financial crises, multiple untimely deaths of loved ones, city relocations isolating them from personal support networks) and each had experienced major depressive episodes during their long term relationship. They were a highly distressed couple.

They fought a lot, at home and in session. For many sessions they would begin by talking over each other, often discussing two different topics within the same dialogue. They talked across each other bringing up all manner of things so that it was hard to make sense of what either was trying to say.

Here is an example of how they interacted:

Jane exploded, voice raised, posture forward, arms and hands raised:  “You didn’t back me, YOU blamed me, YOU always do that, you told the kids I did it for attention, that I am damaged, will never be the same. You made me feel an idiot. You always just do that, then you take over, control everything”

Paul interjected, eyes narrowed and staring, voice deep and loud, fingers pointing at Jane: “I did not! You don’t even know what I did, you weren’t there. I would NEVER think that of you. But you did need help. I was there defending you! You always blame me for everything. Yeah, yeah, I am the wrong one, the bad one. Why do you bother staying with me the? But look, you did need help. I helped, calmed them, explained to them, I also tried to sort you. You were sick. But I told them.”

Jane interrupted : “You told them alright, you just got in there didn’t you? You made me the bad guy, for us all to remember and you the big hero, the big man …”

Jane is aggrieved by what she perceives was Paul’s disloyal behaviour during a time of crisis. In the fantasy of symbiosis, he should be there unconditionally for her. He should act in just the way she wants and expects. Struggling to tolerate the fact that he is a different person with different experiences than her, she is pressuring him to see it her way.   Of course, Paul is angry that his view is not being heard, his good intentions not recognised and he, too, struggles to accept that she can see it very differently from him.

Jane and Paul do not yet each have a way to manage their own reactivity, nor resolve conflict. They deny the impact of their own behaviour and use ineffective behaviours to cope with the anxiety this generates. They are looking to their partner to be exactly as they want. They are inevitably disappointed. A negative cycle ensues as their self-protective responses escalate the other. Attachment systems are triggered and reactivity unleashes.

This type of interaction is typical of a hostile-angry couple stuck in symbiosis, unable to complete the “differentiation” developmental stage. Seeing them as simply stuck in their development allows us to avoid getting focused on pathology and can help us as clinicians to feel less overwhelmed. They do not yet have the skills to assertively define or regulate themselves, nor the ability to make room for the presence of the other as a different, separate entity. The idea that the other may hold a different view or perception is not tolerated.

So what do you do with couples like this??

The Developmental Model teaches us as therapists to take an active role and set the stage to create a powerful start with these types of couples. If therapists are passive in this situation and cycles are left to continue to play out in the room, the couples will lose motivation and feel hopelessness. They will feel there is no difference between what goes on at home to what happens in the therapy room. So it is important for the therapist to hold up the vision of what is possible and for therapy sessions to give them experiences that instill hope.

To lead couples out of these cycles we can as therapists:

• Call a respectful but firm stop to the ineffective behaviours and diffuse conflict quickly
• Normalise people being triggered by their partner’s mere presence
• Get couples to talk to you (through you) instead of at their partner when they are too triggered
• Catch the reactive cycle, interrupt it and describe it clearly so couples can see it in action and recognise that A) stopping it is possible; B) they each have a role to play in stopping it and C) it is possible to talk about what’s going on without blaming and shaming
• Where appropriate, help them recognise their insecure attachment style and take responsibility for the ineffective behaviours this generates
• Assertively refuse to join the negative interaction cycle and laydown clear boundaries
• Build in accountability and ownership for their own behaviour by setting specific individual goals*
• Disrupt the symbiotic pattern, catch the “we” and ”you should” language and thinking, and look for, or help create, the differentiated “I” language and thinking
• Recognise efforts and changes each makes as quickly as possible and give positive strokes
• Help them repair the relationship ruptures; acknowledge and normalise healing, teach calming skills and help partners learn how to take responsibility for their own behaviour and apologize to each other
• Assess for and identify the moments of connection in their broader story and build on these caring behaviours to help the establish rituals of positive connection.

To learn more about how to achieve these steps through our training programme click here

The Developmental Model reminds us that these couples have tremendous developmental potential. As therapists, if we recognise the developmental stages we can identify the developmental opportunities. We can help them identify the internal conflicts that interfere with couple development. We can help them stop triggering and traumatizing each other and repair the ruptures.

Paul and Jane agreed to work on specific individual goals towards being the kind of partner they wanted to be. They focussed on challenging their own ineffective coping behaviour. They practiced tools, in session and at home, that helped them calm themselves down.

It took about 6 sessions before they were really starting to recognise and own this and be able to settle themselves down. Although there were still many ruptures of relationship, both were getting better at recognising the influence of their insecure attachment and realising that not all of their feelings and thoughts had a basis in their partner’s behaviour.

At this point the Initiator-Inquirer Process (“eye to eye” or “i2i”) was introduced. This tool is like trainer wheels for couples struggling with differentiation. It separates out “differentiation of self” and “differentiation from other” into two separate roles so that people can just focus on one aspect of differentiation at a time. On the one hand it helps people learn how to express themselves clearly and cleanly and take responsibility for their contribution to difficulties (differentiation of self). On the other hand it provides training in being open to your partner’s experience, showing curiosity, caring and acceptance of how it is for them without insisting on your own version of events (differentiation from other)

When using the i2i, Jane was firstly asked to clarify what topic she would like to bring up. This was a challenge for Jane as there were many memories of hurt and problems in the relationship. She had to learn to calm herself enough to focus her thinking more clearly. Guidelines and limits were shared: no blaming, criticism or name calling. Jane was asked to express her thoughts and feelings about the issue, to try to be open to learn more about herself, to consider her own goals in how she aims to be as an effective communicator discussing this topic.

Jane had previously been helped to refine her own goals. They included one around autonomy (or differentiation of self) “I want to be able to back myself, believe in my own judgement and experience, independent of whether Paul agrees with my view” and one to claim responsibility for past ineffective behaviours (and, not coincidentally, differentiation from other)“I want to stop shaming him, putting him down, and dismissing him and let him have his view, separate to mine”.

With the i2i guidelines and these goals in mind Jane was invited to discuss the incident that had previously caused her to go on the attack. Here is how she talked about it this time.

“I felt I was blamed for ruining the special family day because of my distress and that the family all looked down on me and that they continue to do so. I felt I did not have you on my side, that I was not backed by you, I felt patronised by you, and that even now, years later the children see me as incompetent, mentally ill. I know it was the illness, the depression was overwhelming and I lost control

In the Inquirer role Paul was working on being an effective listener. He was guided to remember that he does not own the problem, that his partner is a separate person to himself with her own feelings, thoughts, personality and history. His job in this moment was to listen, stay calm, ask questions that took Jane deeper into her experience and not look for solutions. He was able to ask

What did you need at that point that you didn’t get?

In doing this he was signalling strongly to Jane that he was listening and open to how it was for her. She responded like this:

I wanted you to be there for me, to back me, I wanted you to let them know I was vulnerable and it was not intentional but how depression plays outs… I wanted you to be there for me and support me by sharing the knowledge of depression with the kids.

Interestingly she then, without prompting, began to reflect on her own behaviour

I did not ask, did, I? And I think maybe you did try in your own way. I don’t even think I have asked you what you actually said to them. I know now I need to be clearer, I can ask you now, I can get through this hurt, because I still want you to be there for me, I want to repair this with you and the kids. Will you do this with me?”

Here for the first time, Jane began to share her pain, say what she felt inside, express her vulnerability, her thoughts of the event and her wishes for connection with her partner in a way that was so different to what she had tried to do in their past discussions.

Jane experienced a developmental moment defining herself more clearly, taking responsibility for her own feelings and reactions to a very painful experience. She stayed in control as she shared a very painful event with Paul. She reached out to Paul in a way that asked for help rather than expecting or demanding it and allowing space for Paul to have a choice.

Not surprisingly this elicited a very different response from Paul. He listened calmly, nodded as she spoke, focussed on his role as the Inquirer. As she demonstrated more openness his body language softened, he leaned in towards her, tears in his eyes and when she finished he responded within the Inquirer role by first summarising what he understood:

“Jane, I hear now how hard it was for you, on the days before and all that has followed since and how this still bothers you..… that you want to work this out and you want to work this out with me (he looks directly at her and there is a pause) I can see how you have felt blamed, unsupported, judged by me and the kids. That you wanted me there backing you, that you are now not sure what I did do, but that you wanted me to tell them all how hard depression is and how stuck you were.

Then he was able to go on and express genuine empathy for her and a clear intent to work together to do it better in the future

Jane, this has been so horrible for you, I am so sorry, yes of course these memories and ongoing worries trouble you. You want me to help with the kids too, of course, I want to do this with you too.”

At this point Jane smiled, leaned in and reached for his hand.

Jane and Paul are continuing their journey in building their relationship. They still get triggered and have flare-ups but they have some confidence they can do it differently and are seeing the frequency and intensity of their conflicts trending down. When things get reactive, they don’t let them go on and move into repairing the emotional damage quickly.

If you have any questions you are welcome to contact Paula or Nic directly.  If  you want to further your skills and learn more about our training click here. If you want to keep getting our blogs then sign up below

The four magic words are: “…what do you think?”  They do need to be said in a tone that indicates a genuine willingness to hear what the other person thinks but, when said like that, they can work wonders. Tacked on to the end of a critical or demanding statement, this “add on” can take the sting out of the message, flag what is important for the sender and still make room for their partner to have their own opinion (developing “differentiation of other” for those who are familiar with that concept)(if you’re a therapist who is interested in learning about this concept you might want to look at our training).

Here’s an example. Suppose a client angrily says: “I feel like you never want to spend time with me”. That’s pretty unlikely to get a very favourable response from their partner. Most likely it will get something defensive or even a counter-accusation. Now imagine getting them to say it again but with the magic words appended (sincerely): “I feel like you never want to spend time with me… what do you think ? ” Can you, as a therapist, feel how this might create a more engaged, less defensive response in the partner? Try it with something even more extreme:  “You treat me like a piece of crap… what do you think ?”

This is one you can definitely try out on your spouse next time you are feeling exasperated or hurt. When you hear yourself saying some kind of extreme or irrational statement, try adding the four magic words on the end and see if you get a different outcome than ususal.

I’m sure it won’t work all the time but when you see it in action it certainly is less of a “trick” and more a deep secret that can move a conversation through hostility with less wounding and chaos.  Something worth having in your repertoire and trying out when clients are being reactive and defensive; maybe you’ll surprise youself with a little magic.

Nic Beets