You can hear them arguing in the waiting room before you set eyes on them. Sometimes they just blindly continue their fighting as they walk through your door and take a seat, without even stopping to say hello.
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