Confessions of a Couples Therapist, No. 1

Be My Witness

Stop Right There

One of the first things couples often say after our initial meeting is how important it was to finally find time to slow down and talk. There is usually, at this moment, a little smile that creeps onto my face. As one of my beloved teachers and a pioneering voice in the field, the late Alison Lee, used to say: We couples therapists are bossy in the beginning. What the couple often senses, and it can be implicit, is that I am working hard to interrupt them and focus the conversation. The heart of the process relies on listening to and interfering with old patterns of responding to sometimes difficult emotions.

Imagine a child who sees the ice cream truck in the playground. Their body is filled with endorphins and excitement and they jump off the swing and run full speed ahead towards the sweet man selling sprinkles and goodness. Somewhere in the background they hear a loud booming voice: “Get back here right now! I made you dinner, and you’re not going to ruin your appetite.” In these moments, we absorb specific emotional responses to our desires. It is not about whether we get the ice cream or not, it is how that specific drama unfolds and how we experience ourselves in the eyes of another.

Holding Difference

Everyone has some version of their own Internal Working Model (IWM). We have deeply ingrained beliefs and sequences of appraisals about ourselves and others, and while we can sometimes be flexible and consider other points of view, under stress, we typically fall back to our most basic patterns.[1] That is why many couples, for instance, end up seeking help after their first child or when dealing with loss. It is in these overwhelming moments that we are the least flexible and most protective, which has a material impact on intimacy.

The notion of secure attachment has entered into popular language and I overhear people routinely putting themselves into various categories, whether anxious or avoidant or perhaps thinking about themselves as relatively stable. The truth is, secure attachment is not a state of being or something we possess, but it is the hallmark of how we encounter and resolve interpersonal difficulties.[2] When I begin interrupting a couple, literally in the first meeting we have, it is to prevent ingrained, rigid and historical responses from ossifying the conversation happening in the present; when a partner rolls their eyes or pipes in and says “that’s not true” I zero in and ask: “I know you have another perspective, that makes complete sense as there are two of you here, but could I have some space to fully hear what they are trying to say and I promise I will come back to you and understand how you see things.”

Letting the Oxygen In

I am creating the conditions for an important process that allows one to become more embodied in what they are trying to communicate. The point isn’t that the other partner will necessarily hear it or agree, but rather, when we can hold complex and competing emotions and have the space to move as fully through them as we can, we are more regulated, understandable and it has a regulating and calming effect even if what we are inhabiting is challenging and even unbearable.[3]

What this accomplishes is that it doesn’t just rely on the couple having “space” to finally listen and talk to each other, but rather, they are getting out of their own way. I am providing an important stop sign when these habitual anxieties interrupt the thoughts and feelings that are trying to unfold. This doesn’t mean of course that we are not allowed to have opinions about what our loved one says or that we cannot speak up if we hear something that hurts us or that we consider to be untrue.

What I am managing at this point is something referred to as the “Window of Tolerance”. This notion was coined by Dr. Dan Siegel, and it alludes to a safe enough emotional state where we are able to hear another person, and be flexible with our own responses.[4] At its most basic form, when something bothers us too much, we either become defensive by growing bigger and louder, or smaller and quieter to protect ourselves. While this is good for our independent survival, it is terrible for intimacy for the very reason that we become less and less social and receptive the more we feel we are under attack.

I Think I’ve Been Here Before

Many couples come in and frame why they sought couples therapy in terms of wanting to improve their ‘communication’ or because they are ‘growing apart’. While these things are true and quite understandable, what I immediately begin asking in my head about each partner is ‘how have you managed your deep needs for closeness in your life and what is it that you would want known about who you are that would make you feel better’.

Whatever chemistry or compatibility brings two people together, our IWM goes with us wherever we are and romantic relationships are exquisitely positioned to offer a corrective experience. It is true that if a couple comes in after 40 years of marriage and has never examined a pattern that has repeated tens of thousands of times, it is harder to shift the narrative.

Neurophysiologically, there is a common shorthand for Hebbian learning: cells that fire together wire together.[5] It is not that our emotions live in these discrete parts of our brain and nervous system, but rather, our responses depend on sophisticated arrays of connections throughout our brain and nervous system that get reinforced with experience. That is why you feel certain physiological responses to words, thoughts, music, dreams and memories because these states of being live throughout our bodies in comprehensive and significant ways.

The beautiful thing about this is that when I interrupt the pattern in a couple’s speech, reactions and perceptions, that same gravitas of consideration that lives in the body also witnesses the shift. It’s akin to watching a great movie where you find out an aspect of the plot at the end that changes the entire narrative. You do not need to rewatch the movie to understand it through a new lens, you get goose bumps immediately because you can put it all together in a different way.

Reimagining the Past

Imagine a couple who has stuck it out and survived adversity, raised children, moved countries, and then sits down and becomes curious about aspects of their past that caused them distress. You witness your partner reveal that one of the reasons they worked hard and came home late for years was because they were afraid of being a failure. That before you get into an argument, the therapist interrupts your frustration and resentment, and you finally see your partner tear up and talk about their biggest fears. They can finally put into words the shame they felt as a child never living up to their parent’s expectations, and rather than getting into a fight, you hold each other and give comfort to that part of your partner they could never show. While this can be overwhelming and the grief that emerges can take your breath away, rather than negating all those years together, it gives them meaning and purpose and the fear that you held all those years is replaced by a sense of optimism because if you can talk about your experiences in this way, you will have not only deepened your connection, but shifted something fundamental in the relationship.

We call these moments corrective experiences because they offer in real time a different response than the couple was expecting.[6] While it isn’t reparenting in a simple sense, it is accessing the primary longings we have to be seen and understood. It’s a ground clearing of sorts where we examine how our perceptions might have been interrupting the capacity for the relationship to listen to historical resonances that are understandably difficult to hold when we are in the day-to-day, going to work, trying to get in our exercise and surviving.

I always say that couples therapy is not that you come to my office and talk about that relationship over there, but that the session is the relationship; it becomes just as much a part of the daily life of the relationship as brushing your teeth or going to see a movie. I have been inspired, touched and encouraged by the hundreds of human beings I have met over the years daring to reveal how they want to be loved and where they have felt misunderstood and alone. Feel free to let me know what, if anything, touched you here and I’d be glad to consider it for my next piece in this series.

* * *

Clinical examples are composites drawn from patterns encountered in practice, and identifying details have been altered to preserve confidentiality.

---

Notes

1. John Bowlby, Attachment and Loss, Vol. 2: Separation: Anxiety and Anger (Basic Books, 1973).

2. Mario Mikulincer and Phillip R. Shaver, Attachment in Adulthood: Structure, Dynamics, and Change, 2nd ed. (Guilford Press, 2016).

3. Susan M. Johnson and Paul S. Greenman, “The Path to a Secure Bond: Emotionally Focused Couple Therapy,” Journal of Clinical Psychology 62, no. 5 (2006): 597-609.

4. Daniel J. Siegel, The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are (Guilford Press, 1999).

5. Donald O. Hebb, The Organization of Behavior: A Neuropsychological Theory (Wiley, 1949); and Carla J. Shatz, “The Developing Brain,” Scientific American 267, no. 3 (1992): 60-67.

6. Franz Alexander and Thomas M. French, Psychoanalytic Therapy: Principles and Application (Ronald Press, 1946).