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NP0038: Who’s Afraid of Couples Therapy?
Welcome to our “Who’s Afraid of Couples Therapy?” This exciting series, back by popular demand, is based on our November/December 2011 issue on this topic and will explore the challenges of couples work.
What are the most effective strategies in working with couples? How can therapists structure therapy—particularly in the early sessions—so that couples leave with a sense of hope, rather than frustration? Can working with individuals who have serious issues in their relationships actually be detrimental to them? Find out the answers to these questions and much more. In this first session with expert couples therapists Ellyn Bader and Peter Pearson, the creators of the Developmental Model of Couples Therapy, you’ll find out why clinicians often avoid working with couples and how you can better prepare yourself for couples therapy work.
How can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions.
What happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists.
Is it possible to rebuild trust and intimacy in a couple’s relationship after a partner has had an affair? How can therapists help? Hear from Esther Perel, author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence, on how to help couples after an infidelity and the role that cultural perspectives have in this emotional situation.
Explore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection.
Hear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy.
Join Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships.
Discover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries.
After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.
Whole Psychiatry: Alternatives to Conventional Psychopharmacology with Robert Hedaya
Meds: Myths and Realities: NP0035 – Session 4
Is psychopharmacology is a 'go-to' in your practice? Join Robert Hedaya as he discusses how to treat the bodily systems that underlay many mental health issues while avoiding medication. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.Tough Customers: Is It Them or Us?
By Rich Simon As therapists, many of us practice in two different worlds. In the first, we see polite, well-behaved, articulate clients with solid values. They engage fully in therapy, talk cogently about their problems, listen attentively to our responses, make reasonably good-faith efforts to follow our suggestions, and sooner or later get better. No wonder we genuinely like these people! 
 NP0015 21st-Century Trauma TreatmentThis blog focuses on discussion regarding the course NP0015 21st-Century Trauma Treatment: The State of the Art. NP0015, Trauma, Session 6, Diana FoshaDiscover an attachment-based approach to healing trauma founded in affective neuroscience with Diana Fosha, the developer of Accelerated Experiential-Dynamic Psychotherapy (AEDP). Learn how to build a relationship with clients as a trusted “True Other” and enlist clients in a process of dyadic affect regulation that’ll allow the client’s latent resilience to develop.
03.13.2012 Posted In: NP0015 21st-Century Trauma Treatment By Psychotherapy Networker
Afterward, please let us know what you think. Do you have any questions for the presenter? What was most interesting or relevant to you? We encourage you to include your name and hometown with your comment, and to take a few minutes to read and response to other participants’ comments. As always, if you have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments  |
© 2013 Psychotherapy Networker
Lovely feedback to receive -- reassuring that genuine engagement comes across and trumps cyber-flattening. If your experience of this interview was both intellectually stimulating and emotionally moving, then indeed Rich and I did good. Thank you also for sharing something of your own process.
Thanx for sharing your experience of rapidly putting into practice both seizing a moment of transformance, and also then metaprocessing it. Being on the lookout for these moments and "working them" yields important resources and also strengthens the attachment bond.
I am so pleased by your response to the interview -- and very much appreciate your making the language of AEDP your own by asking me to "make the implicit explicit" with respect to the difference between productive (or adaptive) emotions and emotions which are not productive. Or another way of putting it, the difference between emotions that ARE transforming, and emotions that NEED transforming. Adaptive emotions are those that are (i) wired in and (ii) when processed to completion, unleash resources and resilience. With holding and support, they are also regulated. For instance, the core categorical emotion of anger, when processed through to completion gives the individual access to empowerment, strength, and assertive energy which can be put to use on behalf of the self for protection, assertion, etc. On the other hand, emotions that are not productive or what in AEDP are called pathogenic affects are usually dysregulated and rarely pure: they are usually mixed in with fear and/or shame. There is no completion and there is no accessing of resources: to the contrary, focusing on experiencing pathogenic affects is often re-traumatizing, and if anything depleting to the individual. I go into this in some detail in my 2003 paper which I provided for you guys. it is also a theme I discuss in other papers (2004, 2005), which can be downloaded free of charge on the AEDP website, at www.aedpinstitute.com
Nevertheless, i hope this begins to answer your very important question
So great that cyber communication undoes geographic distance. thanks for your thoughts and also your sharing your own work with couples. indeed, focusing on resilience, and " on what works" and then deepening it experientially [and then, a la AEDP, also METAPROCESSING that] is a very powerful way to work.
Thanx! So glad to receive your response.
You asked to hear a bit more about the woman who, after feeling my care, realized that she had not been mothered. Here goes: While this woman and I had made a very good connection from the beginning, she always fought it, dousing in suspicion my affirmative responses to her, as well as my appreciation of her: she was wary that they were "technique." That's why the "high 5" moment was so great -- it snuck under the radar (and in fact we had done a lot of previous work on this isssue). She got in touch--fighting it all the way because of the deep grief the awareness causes-- with how she had no mothering to speak of. No protection, no tenderness, no care.
You then write: "Does AEDP begin the process of healing by helping clients notice what real connection feels like and then with that support, they are able to grieve issues such as abuse or abandonment by a parent?" The answer is yes.
In AEDP, we help clients notice AND we also seek to help clients experience the real therapeutic connection (when it is there), so indeed we are connection detectives from the get-go: once we find it, or glimmers of it, we seek to make the implicit explicit and the explicit experiential. That's how we work: indeed first with the real connection in the here-and-now.
We also do the same thing with clients' resilience, or in AEDP language, transformance. And then we become transformance detectives. also from the get-go: once we find it, or glimmers of it, we seek to make the implicit explicit and the explicit experiential. Both of these activities are deeply resourcing and help and strengthen for the work ahead, when we will indeed work with grieving issues of abandonment, neglect, and abuse.
So that's one mechanism, a general one of the action of AEDP. Another one is the example I used with the woman, when doing the work on good solid experiences in the here-and-now triggers, by contrast, an awareness and an experience of how terrible and different things were back then
You also ask about whether AEDP has any special ways of working with grief. In AEDP work, that's state 2 work and a lot of it involves portrayals, as we focus on helping clients process grief, and process it to completion.
However, there is another aspect of AEDP work with grief, and that is quintessential AEDP: in the course of doing the trauma work, a transformational process arises, sometimes in response to work on the deep and solid therapeutic relationship now, sometimes in response to trauma- and grief processing. In AEDP, we call this transformational process "mourning the self." When we experientially work with this, and process the emotional pain associated with mourning the self, out of this work rises a deep self-compassion. And as shame, and self-loathing and low self-regard are such huge issues for trauma and traumatic loss survivors, the development of compassion for the self is a profound therapeutic accomplishment.
Thank you so much for your questions and the opportunity to share more deeply and explore some other aspects of AEDP's approach to treating deep attachment issues as well as trauma
What a treat to watch this interview between you and Rich.
I wanted to go a little deeper into the wonderful articulation of working with grief that you gave to Lynn and productive/unproductive affects addressed in Rob's questions. While in the process of mourning the self I have had clients drop into what feels like a very crucial examination of their own roles of perpetuating similar experiences and relationships as they initially had with abusive/abandoning caregivers. This inquiry into the construction of their relational patterns feels really important in the shift from an identification as a victim in more current relationships and being able to feel more empowered, as well as really seeing the costs of their defenses. For a client I have in mind it was pivotal in feeling more self-efficacy and undoing the pathogenic patterns of her relationships. However, it felt so delicate and feels like a client could easily slip into a vortex of shame, self-blame, and anger directed at the self. I feel and witnessed that there was something deeply transforming that was unlocked when she looked truthfully and openly at the ways she was abandoning herself. She could tolerate going there with my support. I have used the relationship and parts work to work with this and other clients and we were able to move to a transformation in their assertiveness and undoing patterns and relationships that were not serving them, but I was wondering if there are additional ways to work with this? Each time it feels so edgy and on the brink of that vortex and a tightrope walk between productive and unproductive affects. This issue feels so important to me in working with trauma and attachment challenged people.
Thanks so much in advance!!!
You raise a powerful issue -- i think being able to help patients examine their role in perpetuating traumatizing relationships is hugely important and indeed a delicate balance. So often, therapists tend to shy away from these areas, using empathy to avoid the difficulties intrinsic to the situation you describe.
And indeed, when we do venture forth and really support patients' exploration of this crucial area, it is, as you wrote, "edgy and on the brink of the vortex and a tightrope between productive and unproductive affects." Doing the work slowly tracking moment and moment and with the deep and active support for the therapist is essential. However, a tightrope is a tightrope, and it is not always possible to stay on.
This is when AEDP's understanding of the process of attunement, disruption/rupture, and repair is so important, accompanied by the understanding that, if repaired, disruptions/ruptures are huge opportunities. Because of this tightrope and how easy it can be to temporarily fall off, people tend to stay away from grappling with these issues.
The additional way is always learning from the faLL: process and metaprocess the rupture and its repair, that it was repaired, validating just how difficult this terrain is for both members of the dyad. I would work collaboratively with the patient, on what we might do differently next time we are walking the tightrope. And in the process, the patient and therapist working together together, connected though their bond, keep strengthening that bond through going through this stuff together AND coming out the other side. in the process, resilience is enhanced and the patient is more resourced for next time. So is the therapist, equipped with this knowledge.
cheerz
diana
Thanx so much for writing -- if so inclined, do let us know how next session goes, for it sure sounds like the last one with this gentleman was so very powerful -- for both of you, actually
Warm regards
Diana
This session was so rich-- I would love to watch it again and again! So many great ideas... "surprise the unconcious, sneak underneath the clients' defenses, see how what they're trying to accomplish is already there, stay with me, make the implicit explicit, undoing aloneness"-- the list goes on and on! Given that the therapeutic relationship is so important in trauma work, your model makes so much sense. I would love to "see you in action," even in a simulated situation. Do you have any videos available? I feel that this would really help me to incorporate these concepts into my work with all of my clients.
Thank you!
Marybeth
Thank you for your comments -- I in turn feel seen and heard. To date, there is one video of my clinical work which is available to the public, issued by APA -- you can get it through the AEDP website at www.aedpinstitute.com, or from APA itself:
Fosha, D. (2006). Accelerated Experiential Dynamic Psychotherapy with Diana Fosha Ph.D. Systems of Psychotherapy APA Video Series # 4310759. www.apa.org/videos/4310759.html
I also teach from clinical videotapes of sessions with actual patients -- and i am doing a bunch of trainings June & July, and then again in the fall. Again, the place to check these out is at the AEDP website, www.aedpinstitute.com
Btw, if you have trouble getting through any of these links, you can contact our AEDP administrator, Ginny Vaughn at v.vaughn020@gmail.com
all best,
diana