Filtered by category: Clinical Topics Clear Filter

Reliving Terror

At the end of my last post, I wrote about the shame connected to childhood abuse that must be relived in couple relationships.  Couples in which one or both partners were victims of childhood abuse will likely also be reliving terror.

Read More

Reliving Shame

Because the emotion of shame usually derives from having done something “wrong” in the eyes of significant others, it is inevitably part of every important relationship.  That look of disapproval or disgust that accompanies shame-filled experiences is such a blow to our self-esteem that creates so much subjective pain; it is no wonder we avoid this feeling.  This leads to unmetabolized shame that is going to be relived in couple relationships.

Read More

The Dysregulated Emotions of Trauma

When couples come to us for treatment, they have frequently been struggling with the dysregulated emotions of trauma.  Their right brains have been correctly mutually creating an outlet for these unmetabolized emotions through their recycling dramas, but the partners usually do not know what to do with them and have almost always developed a sizable amount of fear around their expression.

Read More

Why Relationships MATTER

To mask or not to mask? Anti-vax or total vax? What will we most remember from the COVID crises?  “Relationship deprivation” may be the primary memory for many. Just how vital are connections to our sense of well-being?

Read More

Elements of Treatment Success Beyond our Control

Another way of thinking about this post might be the old adage, “You can lead a horse to water, but you can’t make him drink.”  Couples therapists are not responsible and cannot control the timing of a couple’s desire to be together or their readiness to use therapy.  Every person’s right brain (nonconscious) is completely in charge of their ability to tolerate the unearthing of childhood experiences and feelings.  Our brains are programmed to protect themselves, and they are absolutely correct every time about what might create mental disintegration.  So, our clients’ right brains are in charge of the treatment; not us therapists.

Read More

Roadblocks in Therapy

Every skilled couples therapist needs to have some ideas about what to do when the treatment doesn’t seem to be working.  Fears of failure begin to creep into even the most experienced of us, so knowing how to identify the roadblocks in therapy can help us redirect the work and reduce feelings of responsibility for elements of treatment success that are beyond our control.

Read More

Love.....and Relationships

Love is patient

Read More

Clinician Need and COVID Fatigue

After nearly 24 months of life turned upside down by the worldwide COVID-19 pandemic, how are you doing? I’m certain you regularly ask others a similar question, but when was the last time someone asked you, or you even asked yourself? As clinicians, we pivoted from in-person to telehealth multiple times as the numbers grew or diminished. We altered policies and practices, learned new modalities, and experienced uncertainties personally and professionally. As social workers, we have been challenged with personal health and financial concerns, feelings of loss, guilt, and have at times felt ill equipped by our training to navigate the unprecedented changes which have been required. Social workers struggled to meet the needs of clients through virtual settings and to address complicated social justice issues which have been exacerbated by the pandemic. The many challenges associated with the pandemic require us as social workers to recognize the personal and professional toll this has taken. 

Read More

Mining Conflicts

In previous posts, I have explained why it is countertherapeutic to shut down the repetitive conflicts that bring couples to therapy.  Within those conflicts are the unmetabolized feelings that their right brains have been waiting to experience and voice.  The therapist’s job is to mine their conflicts for every possible ounce of meaningful emotions that the couple has been trying to bring to consciousness.

Read More

Self-Reflection

What makes social workers successful? What do we strive for? How do we find contentment in our profession? After almost 10 years as an active duty social worker in the Air Force, my search for the answers to these questions is still a work in progress. What remains meaningful to me are the core things that brought me to the profession--my passion for helping, my desire to advocate for social justice issues and for those in need to receive appropriate support and services.  Some days I am more successful than other days and I must admit making time to observe my thoughts does not always come naturally.  

Read More

Therapeutic Response to Needed Conflicts

Conflicts in couple relationships hand us the potential for profound, deep, permanent change “on a silver platter”.  Knowing how to respond to this opportunity is the key to effective couples treatment.  Too often couple conflicts make therapists anxious, and they prematurely shut down the most fertile ground for empathy and understanding.  In a previous blog post, I addressed the concept of regulation.  This should be an end-goal for the work; not the first reaction from the therapist.

Read More

Needing Conflicts

The concept of needing conflicts is central to understanding how Neurodynamic Couples Therapy heals.  Some other forms of couples treatment characterize conflict as simply an important avenue for communication and negotiation between partners.  A popular notion of marital health says that couples have to fight in order to work out their differences–i.e., partners who fight together stay together.  Our idea of needing conflicts is quite different from these.

Read More

A Daughter's Dilemma

Mami always told me, “when I’m no longer able to take care of myself, put me in a nursing home…my dignity is very important to me”.  These words and personal preferences were shared, by my now 87 year-old Mother, close to twenty years ago. At the time, Mami was physically healthy, and her mind was clear and strong. Other than never driving or speaking English, she was self-sufficient and a great role model to all her six children. At the young age of  thirty-seven, she managed to raise her four daughters and two boys on her own, after my father passed away. She was as beautiful as she was focused and her sole purpose in life was to be  a loving  parent and ensure that all our needs and necessities were met.  

Read More

Transformation

Some form of transformation is the stated or at least implied promise of most types of psychotherapy, including Neurodynamic Couples Therapy.  The term literally means “changing form”, although Google goes further and says that transformation is some type of extreme, radical change.

Read More

Reading the Room

Every good comedian knows that in order to be successful at their job they must be adept at reading the room.  This means watching the body language of the patrons in the audience, looking for signs of inattention or boredom, and being able to feel whether there is a connection with their audience.  An entertainer who does not have this skill can quickly lose the audience.

Read More

Mutual Empathy

The previous blog post ended with the question “What comes after wondering?”  The answer is mutual empathy.  Wondering and exploring about the meanings of intimate partners’ triggers and the feelings they expose must lead to empathy in order for metabolizing to occur.  I have had occasions when a consultee will say about a couple, “They seem to understand each other, but they’re not getting better.”  They are not feeling their partner’s pain; the work is remaining intellectual.  Without the final step of empathy, the feelings will recycle back into the right brain to be relived another day in another drama.

Read More

The “Wondering” Spouse

The ability to wonder is an amazing capacity of the human mind.  Wondering springs from genuine interest in knowing what happened, what was its meaning, who was involved, what did they feel and why.  One school of psychological thought says that in order to be able to wonder we must be able to mentalize.  This basically means that we must be able to think about ourselves, our experiences and our feelings.  Essentially, we must be able to feel and think at the same time in order to wonder.

Read More

What to Say That Fits the Frame

As I have written about before, the goal of Neurodynamic Couples Therapy is the metabolizing of emotions that leads to integration.  We believe that this process is a naturally healing function of partner relationships.  So, whatever the therapist says during treatment should be in service of fostering the metabolizing process.

Read More

Maintaining the Therapeutic Frame

All types of therapies have a therapeutic frame that defines the boundary around what the therapy is and what it is not; what it does and what it does not do.  Neurodynamic Couples Therapy is a right-brain therapy; many other forms of couples treatment are left-brain therapies.  It is outside the frame of Neurodynamic Couples Therapy to utilize cognitive or behavioral interventions to change the behaviors of the couple, but that is often what our clients are looking for when they first come to treatment.

Read More

The Roles of the Couples Therapist

The roles that couples therapists perform with their clients depend on the approach to therapy that they prefer.  They can be advisors, experts, coaches, educators, facilitators, provokers, observers, diagnosers and many other roles throughout the course of the treatment.  Here I want to clarify which roles the neurodynamic couples therapist does and does not perform.

Read More