Skills

Sticking Step 2

I don't know about you all, but for me Step 2 is where everything gets stuck. I feel like if a couple can do a really good Step 2, we are going to have traction to work together. Lately, I feel like I haven't been really anchoring us in Step 2, but moving too quickly to Step 3 and trying to understand the primary emotions. I often do this when I think the couple won't be able to really do a Step 2 because of their level of self-awareness, and so I'm trying to jump ahead so they can hear that their partner has something underneath this never-ending repetitive conflict.

In attempting to do Step 2, I see that clients can often notice the more obvious aspect of their action tendency, like if it's shutting down or turning up the volume. I think it's harder for them to see if they are minimizing or dismissing, or becoming critical, because in their minds they are genuinely feeling the truth of those places. They truly think their partner is over-reacting, so they don't see it as dismissing or minimizing. They honestly believe they are just trying to explain to their partner what the problem is, they don't feel that they are being demanding or critical. 

With clients who struggle more with self-awareness, I can go into trying to get them to see their action tendency, try to get them to see it's a problem for their partner, and that it's not giving them what they want. In these sessions I become like a giant truck stuck in the mud, flooding the gas while the wheels spin in place. Everyone gets frustrated, it sounds like I'm telling the client they're doing something wrong, they get defensive, and then I need to apologize and repair.

I saw my boss, George, for supervision about this and he had the most brilliant advice. I came in saying, "George, I can't get them to see their action tendency as wrong." And he said, "You don't have to." Talking to him helped me re-envision how I could go through a Step 2. 

Hypothetical Conversation

Me: What do you do, when you feel all this frustration, once again this problem has come up, how do you let your partner know you're struggling? (looking for action tendency)

Pursuer: I just tell them, I explain what I'm feeling. (their partner has said they relentlessly go into a critical attack for 20 minutes)

Me: So you explain, you're trying to reach out to your partner and let them know, this is hard for me! This is getting in the way of us being connected!

Pursuer: Yeah, I just tell him.

If I were to encourage the Step 2 enactment here, "I do do that, I explain to you I'm upset when I'm feeling upset," I think that would feel ridiculous to the Pursuer, and since they don't see anything amiss with their action tendency, the Withdrawer isn't getting anything from this owning.

Me: So you explain, when you (repeat cue) and feel frustrated, then you start telling him about your experience, and then we're hearing from him that it gets really flooding, it's hard to stay present, he starts to feel attacked. (I'm challenging a little here, and bringing it back into the cycle, wanting them to see that their partner is reacting to them)

Pursuer: He just needs to be a man and be strong enough to listen. (ouch)

Me, after George's advice: That would be so hard! You feel like you are just trying to share your feelings and thoughts to this person you love, it would be so hard to hear that that overwhelms him. (not trying to push the awareness, just staying with the validating)

Pursuer: It's ridiculous! I'm just talking normally, why on earth can't he just hear me and respond? I've told him 1,000 times I just need him to listen to my feelings.

Me: It's so frustrating, when you're already upset, and wanting to go to your partner and seek a resolution, and you share your feelings and then that's a lot for him. That would feel almost kind of helpless, I would guess? (again not pushing them to see the unhelpfulness of their action tendency, just validating).

Pursuer: Yes, that's why we're here, we need tools to help him listen to me.

*possibly repeat this 5 more times to try and get them to soften a little*

Me: Would you tell him this, right now? Could you turn to him and tell him, "It's hard for me, I just feel like I'm sharing or explaining my experience, and then I hear that it shuts you down, and I lose connection with you even more in those moments?"

*process enactment, which in this fantasy goes AMAZINGLY well*

Me, recapping: It is really difficult to take in, when you're just wanting to share your feelings and try to get some resolution with this person you love, and the more you are explaining, the more you (Withdrawer) are hearing you've let this woman you love down, the more you hear you've disappointed her, and it's so hard to stay in that conversation. So the more you explain, the more you shut down, and the cycle starts pushing you both further apart. Am I getting that right?

 

What do you guys think? How do you move through Step 2 with clients who struggle with self-awareness?

When Everything is Failing

Last week was one of those weeks where I felt like the crappiest therapist. I had some sessions where I felt like nothing I could do was making anything better, and in fact might be making things worse. Wonderfully, there has been a lot of interesting stuff in the EFT community in the last couple weeks about working with tough clients, mainly clients who struggle with self-awareness. Thank you, EFT Universe!

A clinician posted a question to the listserve about how others work with clients who struggle with self-awareness, and there were some great responses. Patti Swope’s response helped me the most. She shared she can also “get caught in ‘trying to help them see’ big time, and it’s what I do when I’m frustrated.”

Those words felt like a huge rush of relief and understanding for me. I realized that’s exactly where I’ve been caught, trying to make my tough clients see what they’re doing and what gets in the way of what they want. I get frustrated with them, and then my work gets crappy. These moments are where I find myself saying the most ridiculous things, and realize I’m in a cognitive battle/cycle with the client. I’m not even going to tell you some of the things I said in session last week, they are so embarrassing.

I also scheduled numerous supervision sessions, since I was freaking out about how badly everything seemed to be going. I saw my former individual supervisor, who I just love. She doesn’t do couples work, however she’s a genius at conceptualizing and also holding the mirror up to me. She reflected to me that I’m approaching some of these clients with an urgency that I need them to be different, so that they can stay in this relationship. She pointed out with my cognitive clients I seem to be chasing them around the room, trying to wrap my logic around their cognitive illogic.

I also watched Annabelle Bugatti’s interview with George Faller and it was so helpful. I’m so grateful to Annabelle for her work in bringing us her wisdom and the wisdom of others. George talked about anger in a way that really helped me see how much I’ve been trying to avoid or damp down my client’s anger, instead of truly validating it.  You should absolutely watch this interview here.

DIAGNOSIS:

So, all of this information and feedback helped me diagnose my problem:

I have been on a little rampage, trying to get my clients to see themselves and be different, in part because they (sometimes both clients) are so angry and escalated. And that has been increasing my anxiety and frustration, and feeling of helplessness.

SOLUTION:

The clinician who originally posted the question followed-up later and summarized the solutions she had heard. She wrote therapists seemed to be following two different camps:

1)   The gentle confrontation – gently asking a client if we can give them some feedback, expressing concern this may injure our relationship, helping hold up a mirror to where we see them not being able to see themselves.

2)   The relentless validation, really trying to understand where they are coming from, and validating their secondary emotions in a way that fits for them (matching affect, really getting into their anger versus trying to get under it). This is also the method George talked about. And most importantly, letting go of the outcome.

 

I think it’s a difficult balance, as therapists, of what we do with the idea of the outcome. On one hand, it helps us hold hope, dig in deep, work very hard, and have stamina to be working towards an outcome of togetherness. On the other hand, it can really drive my pursuer, and I start to pursue my clients and need them to be different right now, for fear they will lose their relationship.

So today I’m trying to sit with not desperately trying to get clients to see themselves, but staying more in my curiosity to understand their experience. I’ve also had to really ramp up the interrupting and deliberate ignoring of cognitive exits, which isn’t my favorite way to practice but has been necessary to stay on target. Whew – what a week! How do you come back to yourself when you’re starting to feel run ragged by intense sessions?

Counter-Transference in a Couples Session

I’ve been struggling a little more lately on how to work with the counter-transference that comes up during a couples session. In working with individuals, I do a fairly good job remembering that everything happening between the client and myself can be processed, and usually where some of our best work comes from.  But even with believing that concept, I still slip out of the heightened awareness of our process too easily. I start to notice I’m feeling dread about seeing certain clients, or drained after our sessions. It takes a while for me to wake up and remember that I’m feeling this way because something is happening between the client and myself that I’m not naming or processing in the room with them. I’ve had some zingers from clients in couples sessions recently, and I leave feeling so crappy from those sessions. I mostly know what to do with those in individual sessions but don’t know yet how to process them with couples.

A friend introduced me to a book recently called The Intimate Edge, by Darlene Bregman Ehernberg that has helped me start to think of answers to this question. Here was the process of that conversation:

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Friend: “You should read this book, it’s incredible.”

Me: “Ugh, no. I don’t want to read another therapy book right now.”

Friend: “Let’s read it for our book club.”

Me: “Is this going to be a bunch of psychoanalytic Freud crap?” (my friend comes heavily from a psychoanalytic background and lived and trained in NYC until a few months ago)

Friend: “No, read it!”

Me: “Fine, but I’m not going to like it.”

 

Ok, so the book is incredible. It was like a defibrillator to my brain, shocking me back to the reality that I haven’t been using the “between” the client and myself nearly enough. All of a sudden the clients I’ve been dreading for next week, I have a burst of energy for. Ehrenberg reminded me that instead of just compassion and reflecting, I can also use myself in the room and how I’m feeling with a client. This interpersonal, relational way of working was my entire grad school training, but it’s so easy for me to slip out of using myself in this way. And Ehrenberg uses this tool to the maximum, much more so than most therapists I’ve read or seen.

My question now is, how can I use this with couples? When I have one part of a couple that is acting out, rolling their eyes, snapping at me, or acting inappropriate in the room, I want to use this interpersonal work. It’s a tough balance, though, because we have so little time with the couple and often times I already feel like I spend too much time focused on one partner before making it dyadic (between the two of them).

Whenever a client is acting out or reacting strongly to me, I always pause and explore the trigger. But the moment tends to pass quickly. Here’s how the conversation typically goes right now:

Me: “What just happened there? It seems like I might have triggered you just then?”

Client: “No, no, I’m just stressed from my week.”

Me: “Are you sure? I definitely want to know if I hit a raw spot just there.”

Client: “No …” and moves on to talking about stress with partner.

I move on with them, getting back into the couples dynamic.

But by moving on, and accepting their excuse, I am missing something that really is happening for them.  I also could be missing a way they are protecting themselves from me, and their partner. Ehrenberg conceptualizes how clients protect themselves and test their relationships with us by looking at their pain as them deadening themselves to the feeling of desire. They cut off their connection to their own desire in a multitude of different ways, because to feel desire and have it unmet has been so profoundly painful for them. I think this could be an important portal to deeper work with clients, because it is so fundamental to attachment. If they cut off from feeling their desire to be loved and connected in a deep way, it would have a direct effect on their ability to attach with their partners.

I’m playing with how this lens could be used to help our Withdrawers especially, or our clients with disorganized attachment patterns. At some point they will enact that with us, and then how can we use that in the room without it just becoming an individual session? Please share your thoughts if this is work you’ve thought about!

 

Ehrenberg, D. B. (1992) The Intimate Edge, Extending The Reach of Psychoanalytic Interaction. New York, New York. Norton & Company, Inc.

Entering into Stage 2 Work - Are we there yet?

There comes a time in every EFT learner’s journey when they have to step into Stage 2 work. All while I’ve been learning EFT I’ve seen Stage 2 as a very distant place, and honestly I haven’t worried much about it. I thought I’d be in Stage 1 forever, really. Recently, though, one my couples seemed like they were ready for Stage 2 work, and I realized that, for better or for worse, I was going to have to be the one to take them there.

Eeeeeee. I really wanted to just tap in my supervisor or another experienced colleague and say, “could you come do this session instead of me?” It felt like such a difficult risk to take. And in preparing for this, and trying it, I wanted to share it with you in case it’s helpful.

So first, I’m pretty sure I kept us dancing around the end of Stage 1 for like 4 sessions longer than I needed to. But I wanted to be REALLY really sure they were ready for Stage 2. At the end of Stage 1, in Step 4, we are, “reframing the problem in terms of the negative cycle” and speaking from a place of the couple’s underlying feelings and attachment needs (Johnson, 2004). This couple could do that. They got the negative cycle, they could name when they were in it, they could repair after. They understood it was their “freaked out” emotions and panic of losing the other that fueled the negative cycle. They each took responsibility for their actions in the cycle (p 166).

Most important to me was to assess the feeling of their emotional safety. I really felt like they were each wanting to support each other. When one would risk vulnerability, the other would be right there for them. There were still moments of disbelief and skepticism, but never done with bullets.

I still couldn’t be 100% sure it was time. And this was interesting, I thought when I got here it would be more obvious to me. But it wasn’t as black and white as I thought it might feel. What I could feel from the couple is that they were starting to get almost antsy and bored with Stage 1. At one point one of them turned to me and said, “I think we need to go into some of the harder conversations.” So it was interesting to feel their readiness, before my own!

Another component is that these two have a more complicated cycle. They aren’t quite pursue-withdraw, they aren’t quite withdraw-withdraw, and they have flipped roles over the years. One partner is a little softer, the other a little more passionate. So I started with the softer client. They touched more into their view of self, and shared their fear they wouldn’t get it right for their partner if they showed up more. We spent a whole session on this, and I think this was withdrawer re-engagement, but again, more nebulous in their cycle. This went well, and yet also felt relatively low-risk. It felt like they were being vulnerable, but the process was not as high-octane as when we ask the more pursuer partner to reach from their fear. 

Then, it was time to take on the big kahuna.

As the softer withdrawn partner started to come forward, and say they wanted to be there for their spouse, I could see that view of other/self start to pop up for the more passionate partner. They started to question, do you really want to be there for me? These moments make me so grateful for Sue Johnson’s work. It all comes about so organically, it’s amazing to hear clients voice almost word for word what’s in her writing.

I knew I had to ask them to reach from their fear, that it was time, but I was also scared. What’s if it’s too early? What if I’m gauging this wrong? It’s such a big risk for everyone in the room to do Step 5 with the more pursuer partner. We are really heightening their fear, and then as Lorrie Brubacher says, asking them to “feel the terror that’s been running the show, reach out of the terror, and feel being caught,” (Zordich, 2017).   It’s also the one moment (as I understand it) when we don’t stay and process the client’s reluctance to share, like we do every other time in EFT. Every other time we slice it thinner, we make it safer, and we certainly want to make sure it will be safe for them to share with their partner, but this is a time when we have to heighten the fear and ask them to reach from that fear. This is where I hear Sue’s famous words, “I’d like you to try,” from one of her training videos.

The enactment went as well as I could have wanted it to, but I was surprised by how vulnerable we all felt in the room after. Even though the more pursuer partner was caught (beautifully) by their partner, they had still just taken a roller coaster ride in their primary emotions. I was feeling their vulnerability and my own, and hoping I had done this all right for them. It felt raw, and new, and as Rebecca Jorgensen reminds us, a place where all three of us had never been before.

I wish it had felt more black and white, and I could know for certain it was time and I did it all right. But I realized at some point I was going to have to take this risk, and trust all I have learned so far. What was this risk like for you, the first time you went into Stage 2?

 

Johnson, S. (2004) The Practice of Emotionally Focused Marital Therapy: Creating Connection. New York, New York: Bruner/Routledge

Zordich, P. (March 4, 2017) @efttherapist. retrieved from www.instagram.com

Working With Trauma, Part 2

I’m picking up from last week’s post on working with trauma, which you can read here. Last week we looked at how trauma can show up as a partner getting highly triggered by a partner’s seemingly harmless behavior, and how we as the therapist can take our time with that trigger. This week I want to talk about something I think is even more important that we stay aware of, which is when a partner has a competing attachment source they can’t let go of.

I think we’re used to seeing things as competing attachment sources when they look like addiction. We can understand how alcohol, drugs, gambling, pornography, even eating can take the place of an attachment source. And they have the one-two punch of giving the brain a chemical hit, so it’s not only the behavior that is addicting but also the brain really really rewards us for doing them.

But there are behaviors that are more subtle, yet I think they are in the same category of a competing attachment source. (This is not based in any research, this is just my own sense of what I’m seeing with my clients, so don’t set this in stone, just be curious with me). What I see in these more subtle behaviors that makes me think they have similar trauma/attachment roots is that clients feel like a matter of life and death to give them up.

On the outside, these behaviors don’t really look like something the partner would fight hard to keep. For one it might be that they spend several nights a week out with friends. For another it might be that they enjoy playful/kink-oriented sex. For another it might be that they craft for hours on the weekend. It comes up as an issue when clients have found themselves with partners that don’t embrace their specific proclivities or support what they want to do with their down time, and thus conflict ensues. What I see, sometimes, is that even once the cycle has de-escalated, and the other partner has really dipped into their primary emotions, and shared in a meaningful way that they miss their partner and would prefer them see their friends just one night a week, or want to have sex but not playfully or with any kink, or would prefer them craft for just one hour on a Sunday instead of five hours that their partner immediately puts a wall up, and says no. 

When I hit these moments in sessions, in my head it can feel like a record scratch, an abrupt stop to the music. I’m thinking, hold on, their partner just did all the right things! They weren’t blaming, they were speaking from their attachment place, they asked for something reasonable. These moments are where I try to stop and realize we are looking at something that has become a very important source of attachment and self-soothing for the partner. On the outside, it can look like these behaviors/hobbies aren’t that important, and something the client should easily be able to adjust to spend more quality time with their partner. But on the inside, this may have become a very central way the person soothes themselves. Often we do hear clients say, “Of course! All I’ve wanted is to spend more time with you, I just thought you were mad at me all the time.” But for these special clients, I think we need to look deeper to understand what they are holding onto tightly.

Imagine if your parents were unreliable, neglectful, or harmful, but your friend group was there for you. Imagine that unlike anyone else, these friends love you, support you, and have your back no matter what. All of a sudden, we’re not having a discussion about if you prefer your friends over your spouse, but a discussion of giving up time with the only secure attachment you’ve ever really had for time with your spouse, who you may not actually want to risk trusting.

Imagine if you spent much of your time being in a house with a lot of chaos, noise, and abuse. Your brain was likely soaked in cortisol and adrenaline for much of the time (Gottman, 2014). Imagine the one place your brain got to relax, and not experience flooding, was when you were doing crafts. For whatever reason, your family left you alone when you were crafting. Now, this is the central way you know to calm yourself down and protect yourself from chaos. When you partner asks you to spend more time with them and your kids, it’s now a question of how on earth would your brain get the same soothing and relief without time spent crafting.

Imagine if you grew up in a dirty, neglectful, harsh household. Imagine that there were really no joy or play growing up. But once you discovered sex, and kink, you found that this was a place you could give yourself permission to experience joy and play, not to mention positive physical touch at all. Imagine that you had positive experiences with the people you were having sex with, and this became a central way you knew how to feel release and happiness. The idea of standard sex, and sex without play, suddenly is a question of how on earth you could experience those feelings of joy and release at all.

This is why I think we suddenly see a client adamantly refuse to consider giving something up we otherwise don’t see as particularly compelling. Because their brains are immediately reacting to the idea of giving up a central tool for soothing and/or attachment. It’s like if you all of a sudden told me I couldn’t exercise or call my mom if I stayed with my partner. What on the outside might look silly, or even selfish to not give up, on the inside feels like you’re asking someone to give up how they know to be ok in the world, in order to be with this other person.

What I am seeing is if I go really slow around these parts, and am very respectful and validating of what these behaviors may mean to someone, it can be very relieving for clients to their to know I don’t see them as selfish or petty. And what helps me do this is to try and really imagine how someone became a soothing or attachment tool for the client. Something Julie Gottman (2014) mentioned in the Level 2 training on the PTSD section helped me understand how past trauma manifests in marriage relationships. She said that once someone moves from dating, to a "family" status with their partner (this can mean marriage or kids), a lot of PTSD can rear up unexpectedly. Because "family" to that person meant pain, mistrust, and non-safety. So now they are in a new family, but the concept of family is still not safe in general. The person in front of them may truly be a safer and more soothing attachment source than friends, kink, or crafting, but the idea that this is possible may feel totally foreign and frightening.

 

Gottman, J., Gottman, J.S. (2014) Level 2 Clinical Training, Gottman Method Couples Therapy. Seattle, WA: The Gottman Institute