As students, those of us who were pursuing a career as psychodynamic psychotherapists learned about the repetition compulsion. The Oxford Reference (www.oxfordreference.com) defines this phenomenon as “a tendency to place oneself in dangerous or distressing situations that repeat similar experiences from the past.” Webster’s Seventh New Collegiate Dictionary describes a compulsion as “an irresistible impulse to perform an irrational act.”
All psychotherapists know the importance of language. We pay close attention to exactly what our clients say and how they say it. In this post, I will share a case that illustrates how the perfect language of couples’ complaints provide the roadmap for their treatment.
“If you don’t know the language of gratitude, you’ll never be on speaking terms with happiness.” Chopra
Best Practices in Mental Health is a premier, peer-reviewed journal that represents the highest quality scholarship in the field of mental health. With a comfortable format and a broad scope, BMPH is an excellent resource that provides an interdisciplinary and evidence-based focus for its audience of mental health educators and practitioners. Editor Daphne Cain is at the helm of curating new research from recognized experts on established best practices and from leaders in emerging best practices. The hand-picked editorial board ensures the journal keeps with National Institute of Mental Health's (NIMH) priority to promote the integration of technology, replicate and improve promising practices, and continue to provide diverse and enlightening perspectives that allow readers to remain engaged with the best research available in the mental health field.
Most forms of couples therapy are focused on resolving conflicts in the present-day lives of couples who seek treatment. Some methods do delve into the historical antecedents of those conflicts, but their primary goal remains helping couples meet their current needs.
Most forms of psychotherapy require that the therapist perform a “delicate balancing act” between competing forces. Some authors refer to this skill as dialectical thinking–the ability to mentally (and emotionally) hold seemingly opposite factors in dynamic tension in service of moving a system toward higher functioning. In Neurodynamic Couples Therapy, there are primarily three areas in which the delicate balancing of the couples therapist is required for therapeutic success.
A frequent complaint that therapists hear from couples when they enter treatment is that they have felt hurt by each other. They want to tell us all about the pain that their partner has inflicted on them, and they often seem to want the therapist to declare which one of them has been the “most” hurt.
For several years, during annual strategic plan meetings, our ABCSW Board of Directors, brought up the idea of hosting an annual conference for our members. Our goal was to establish a conference where our members, board, and other clinicians could come together to meet, learn, network, re-energize, share ideas and form new friendships, collaborations, and foster professional growth.
What is rage? My sweet little cairn terrier taught me what rage is. One day I put down her feeding bowl, and she started her meal. I needed to move the bowl slightly to get it out of my way. As I reached my hand down toward her bowl, she bit me! She had never bitten anyone before. Since I hadn’t spoken before reaching down, I think she might not have even been aware that it was my hand.
I recently watched Robin Roberts from Good Morning America, interview Glori Tuitt and her Mother, Ruthie Tuitt. The topic for that program focused on how members of the LGBTQ+ community have felt abandoned, unaccepted and rejected by their families and by their religion. Fortunately, some are finding their way back. “Don’t despise the packaging” is what GloriTuitt’s Mother, Ruthie Tuitt, said…”Just because it’s not packaged the way in which you feel it should be, does not mean it’s not a blessing..” She goes on to say that her daughter remains a great blessing to her.
Watching the recent upheaval in our society, more specifically watching the January 6th hearings, I began asking myself the question: Is the interaction in the group a product of individual behavior, or is the group understandable as an intact entity suggesting behavior is a product of the group?
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.
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.
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.
As we celebrate National Superheroes (SW) Month, I am reminded of all the things we do for others….
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?
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.
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.
