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.

Understandably, most couples tend to see their problems as arising out of present issues–how much money should we spend/save? whose family should we visit for the holidays? are we having enough sex? where should we live? whose responsibility is it to take care of the children/cook the meals/clean the house? and so forth.  Couples who have gotten into long-term, repetitive conflicts over any of these types of issues come to us looking for answers.

Their press for answers can be so compelling that the couples therapist feels obligated to set about solving their problems.  The neurodynamic couples therapist knows that all of their conflicts are a doorway that their right brains are attempting to open to the wounded selves that want to be known.  I have often been asked by couples early in treatment, “Could you just give us some tools?”  My answer to them is that the only tool they need is their curiosity–their ability to wonder when upset with their partner, “When he/she does xx, what comes up inside of me? How can I tell my partner about my upset in words that are only about my feelings–not about what they did to me?”

Maintaining the therapeutic frame becomes more challenging when dysregulation in one or both of the partners triggers the therapist into feeling compelled to control what is going on.  There are certain outer boundaries to enforcing safety in our offices that can be brought to bear, but our first impulse must be curiosity about the elements of what a partner is saying that may be coming out as hurtful or aggressive, but are actually the desperate utterances of a wounded child.

The therapeutic frame of the neurodynamic couples therapist does not characterize the couple’s conflicts as problematic.  It interprets the argument presented as providing a script with precisely the right and necessary words for both partners to speak previously unspoken feelings that are the heart of what it has been like to be them.  The immediacy and fullness of the emotional experience of the script is not available unless both partners are present, so our frame requires having both partners in the therapist’s office in order for the treatment to occur.  Experiencing together a partnership with the therapist in transforming their “right-brain-speak” into deeper empathy and understanding in real time creates immense relief in couples, as they watch their usual conflicts lose their power.

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