Emotionally Focused Couples Therapy with Trauma Survivors

In July I went to a wonderful training with ICEEFT-endorsed trainer Kathryn Rheem on working with “those who have endured more than most” in Emotionally Focused Couples Therapy.  I was eager to attend this training because I have noticed that, not surprisingly, a very high proportion of my couples include at least one trauma survivor, if not two.   I say “not surprisingly” because survivors of relational trauma in childhood (or even in adult relationships that preceded the current one), when triggered, will often momentarily perceive their partners, who are their primary source of safety, as a source of threat.  Once past trauma is cued in this way, trauma survivors feel as if the danger is present now and react defensively with fight, flight, freeze, submit or appease reactions, all of which tend to lead to their partners thinking, feeling and behaving in ways that then lead to further upsetting the trauma survivor.  In other words, in couples where a trauma history is present, emotion emerges quickly and chaotically and communication is scrambled.  No wonder couples in this situation end up feeling so distressed, overwhelmed and confused.

The wonderful news here is that, because Emotionally Focused Couples Therapy ultimately leads to stronger bonding between partners, which produces a deep sense of safety, it can actually go a long way towards healing the aftermath of trauma in the individual partners who have survived so much.  On the way to sharing their feelings of pain, terror, and shame with their partners, trauma survivors are helped, very slowly and carefully, to come to know and process these emotions within themselves.  Thus, both intra-psychic and inter-psychic healing occurs.  The less wonderful news is that, the more trauma partners have collectively survived, the slower the healing process will usually be.  De-escalation of entrenched reactive patterns between the partners will likely take longer, and restructuring and deepening the partner bond will likely take longer as well.

The hard work that trauma survivors do in facing and processing the fears that lie behind and below their defenses takes great courage and requires skilled, well-paced, and attuned support on the part of the therapist and the therapist-supported partner.  Giving up coping strategies that have served us well for decades feels like a crazy thing to do.  And the only reason people who have endured so much already would do so in this context is because their coping strategies are now blocking them from getting at what they long for most–the deep sense of security they can earn when risking with, and being lovingly received by, their adult romantic partners.

 

Boundary Setting with Family of Origin Members

In many families, children are raised with certain roles that they take with them into young adulthood, and beyond.  For example, one child might be expected to take care of a parent’s needs and be made to feel guilty if she does not.  Another child might be the one who is always criticized by his parent and never feels that he can gain approval or be good enough.  Yet another child might be the peacemaker in the family, always subordinating her own needs in an effort to make sure that the family as a whole is okay and stays together.

Children usually have little choice but to accept the roles they are given.  And the pull to continue filling these roles is very strong even after they have launched.  Indeed, it is not unheard of for individuals still to be seeking a parent’s approval even after that parent has died.

If children don’t meet their parents’ expectations or otherwise do what is necessary to survive in their families of origin, the consequences could be dire; children are, after all, almost completely dependent on their parents and other family members.  As adults, though, dissonance can start to occur when continuing to fill family of origin roles interferes with independence, authenticity, one’s own values and/or desires, a romantic partner relationship, one’s sense of worth, and so on.  Anxiety, depression and/or romantic relationship strife can result.

In such cases, it can be important for the individual to start setting boundaries with family of origin members through what I call “kind but firm” assertiveness.  And, let’s be clear:  This is not an easy matter, because it involves possibly angering people whom we love, on whom we once depended and with whom we have entrenched relational patterns.

One example of setting a “kind but firm” boundary is saying to one’s intrusive mother, “I appreciate your concern but I need to take care of x [my finances, romantic life, kids, or whatever] in my own way”.  Another example is saying to one’s critical parent, “I know what your expectation for me is but that doesn’t suit me right now and I won’t be pursing that course of action; I’m telling you this because it’s very important to me to have an authentic relationship with you in which you can see me for who I really am”.  Another example is letting a bullying sibling know, “it’s not okay for you to continue talking with me in that way and if you don’t stop I will have to stop talking with you for today”.

All of these kinds of boundary setting are ways of asserting one’s own desires, needs, limits, and so forth.  In effect, the person setting the boundary is saying, “I’m not going to play that old, expected role anymore.  I’m changing my role in the family.  Here is what is okay and what is not okay with me now”.

Usually the result of “kind but firm” boundary setting in the first instance is to provoke anxiety in the recipient(s) of the message.  Everyone is used to the now assertive person playing his old role, and it is very disconcerting to have her do otherwise.  Usually family of origin members will react by trying everything they can think of to drag the newly assertive family member back to his old position.  Protests may be launched.  “Guilting” may occur.  Anger may be expressed.

According to some research on family systems that I remember from counseling school, it takes 15 to 20 repetitions of  (kindly!) standing one’s ground in order to convince family of origin members that one is really not going to return to playing one’s established role in the family.  At that point, the family system will usually reorganize around the newly assertive member’s new position, and a new order will emerge.

And, here again, we return to how daunting, even if necessary, this can be to try.  Even trying “kind but firm” boundary setting once sounds like a huge, scary undertaking to many of my adult clients (e.g., “I could never tell my father that!”).  And when I tell them that they will actually have to do this up to 20 times, they often look at me like I might be from Mars.

On the plus side, though, “kind but firm” assertiveness is one route to liberation from dissonance, building lasting, more authentic bonds with family members, and just plain being able to be one’s self.

 

 

Emotion-Focused Therapy by Phone

One of my clients is ill and disabled enough that we generally do our therapy sessions by phone.  After several years of working this way, we have learned to communicate with one another in a very connected and nuanced manner, even without the benefit of being in the same room or being mutually visible.  Recently we tried something that I wouldn’t previously have thought possible:  a Gestalt two-chair exercise by telephone and without my client moving a muscle.  Purely via verbal guidance, I asked her to imaginatively embody first the part of her that criticizes her, telling her she is a burden to people, ought to be better set up in life by her age, and so on, and then the part of her that has to listen to this critic and suffers the shame and depression that its words effect.

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Towards a Deeper Connection: Emotionally Focused Couples Therapy, Stage II

I have recently been working with two couples in the later stages of Emotionally Focused Couples Therapy (EFCT) and feel very moved by the deep work these partners are doing with each other in an effort to achieve a deep, secure and lasting bond.

In stage I of EFCT, partners gain an understanding of the negative interaction cycle they have co-created and learn to stop it.  A “cease fire” is achieved and partners begin to gain a sense of control over what happens between them and to re-experience what they so much enjoy about their relationship.

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ADHD and Couples Counseling

I just read a book that I think all couples where one spouse has ADD or ADHD (or might) should read.  It’s The ADHD Effect on Marriage by Melissa Orlov and I thank my colleagues on the listserv of the International Centre for Excellence in Emotionally Focused Therapy for recommending it to me.

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