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Therapy

Is There a Right Time to Stop Couples Therapy?

Relationships are never free of “issues," in or out of therapy.

Photo by Joy Dryer
Source: Photo by Joy Dryer

“I think we’re ready to stop,” Eddie says.

This session was about 8 months after Eve and Eddie started PACT (Psychobiologic Approach to Couples Therapy)4. They sat facing one another, knees almost touching.

Eve leaned forward, cocked her head, and looked directly into Eddie’s face. “I know I agreed with you when we talked. But now I’m not so sure.”

It was Eddie’s turn to cock his head. “How come? I thought we agreed that we’re doing better?”

“M-m-m. Yeah, lots is better. We fight less. And when we do, we know how to walk around to the other side of the mountain to try to see the other’s perspective. So we repair pretty fast…“

Eddie was leaning forward now, too. "...and I’ve leaned in more to help calm you when I notice you heading toward an amygdala hijack…I mean, I’ve worked hard to be more present for you…Haven’t I?” I can see his neck muscles tense up.

"Yes, yes. We’re talking more. Sharing more. I feel we’re more of a team." Eve paused. She seemed to struggle for the right words. "I mean...I do feel more trusting…and I too am working hard to be more vulnerable…”

“…and with all that, our sex is better…more frequent, more fun…" Eddie struggled to find the problem, with his eyebrows raised in a questioning look.

“I know, dear." Eve responded to Eddie’s bid for acknowledgment with a small smile. “But you’re crowding me now with your words…I think more slowly than you…give me space to try to explain what I’m feeling.”

I thought to myself: OK. Progress. I see they are mutually regulating as they try to figure out what’s happening. I stayed quiet to see how they collaborate working in the same foxhole together—on the same team.

Eve paused. “I mean, when we first started, I thought you were a complete ass, gaslighting me about your affair with Amy at your office. I’m sorry again that my criticisms pained you and pushed you away from me… “

He responded, "and I’m sorry also for how uncommunicative I was—disappearing into my head like I did when my Mom screamed at me. Because I wasn’t, and am not, having an affair.”

I thought: Apologies always help repair the ruptures. But Eve was sounding like she still did not believe Eddie. I decided to challenge them both. “I can see that you are both trying to help the other feel less anxious now. That’s fine. But what’s the issue right now? Are you afraid to know?”

Eve shifted in her chair. “Look, what started to turn the corner for me was that session when we talked about our parents. How absent, misattuned they were. How our relationships with our parents were repeating in our marriage. I remember your saying, ‘I’m not your Father, with all his mistresses.’ Wow. I started to realize this was not about our parents, that we needed to look at you and me together.”

“Yes. And we did shift to 'we' thinking, rather than 'me-thee.'" Eddie reached for Eve’s hand. I saw that she moved it slightly out of his reach.

Eddie noticed too because he blurted out, “Do you still think I’m having an affair?”

“No. That’s not what I think…in my head," Eve responded. “But in my heart—look, it was hard to allow myself to know how afraid I was to feel vulnerable with you, to feel safe. And I blamed that on you. OK. So I feel my own fear now. I still think I’m scared to be so open to you." She paused. "And….“

Eddie and I waited. Breath paused, too.

“…and, well, I feel ashamed to say this. It’s the looking stuff that still bothers me.”

Eddie and I both looked at her, puzzled.

“Well, when you look at me, I do feel that you see me. I’m trying hard to let you really know me. But I still feel jealous if I see you look at other women. And if you stay late at work sometimes, I can’t stop my brain from wondering if Amy also is working late with you.”

Eddie audibly exhaled. “M-m-m-m. You mean your head knows I’m not, but you feel the opposite?“

Eve lowered her head. “Sometimes," she said quietly.

“I’m sorry you’re still struggling with that.”

That’s good, Eddie, I thought: Empathy first — always a good approach.

“As you were less critical of me, I too felt safer and could approach you more.” Eddie paused. “I’m glad you’re telling me now without blaming me. For me, it means we can keep working on this as a team. I mean, when you feel mistrustful, can you tell me? And I’ll do my best to reassure you."

We discussed how Eddie’s withdrawal triggered Eve’s lack of trust—triggered her connecting handsome husband with her handsome Father, her affable friendly husband with her Father having numerous affairs. She breathed in her parents’ tensions.

To Eve I said, “Differentiating your past childhood experiences, from your relationship with Eddie, may be an ongoing struggle.“ To Eddie, I said, “You can continue to support Eve in her struggle without feeling like you’re accused of a crime.”

“Calling out such reality may be hard to accept," I continued. “Since many folks have the idea that all problems need to be solved in order to stop therapy. Not so." We go on to talk about how they grew up with differing insecure attachment styles. But they “earned (their) security” by growing beyond their problematic and painful childhood histories3. “You’ve learned, and are using, many tools. You can continue to deal with uncertainty, mistrust, jealousy, and other difficult feelings, and stop therapy at the same time."

They agreed to continue for another month to get accustomed to holding opposite, sometimes conflicting, emotions at the same time.

Post Session Notes: A-B-Cs for Creating Safety

Eve still felt betrayed, even if the affair was her fear, and not reality. But they’ve made progress, by actively practicing these A-B-C principles:

  • A: Awareness. Attachment style and the ability to be a “We"—to live in the same foxhole together; "we” replaces “me/thee.”
  • B: Behavior. “Walk around to the other side of the mountain” to listen to the other’s perspective.1
  • C: Conflict Resolution. Our brains are wired to pick up negative environmental threats, which can lead to an “amygdala hijack,”2 i.e. a defensive reaction—one of the 4 F’s: Fight, Flight, Freeze, or Fade (play dead).

The A-B-C’s are not automatic, but areall learnable skills.

References

(1) Fonagy. P., Gergely, G., Jurist, E.L., &Target, M. (2004) Affect Regulation, Mentalization, and the Development of the Self, N.Y., Other Press

(2) Goleman, D. (1995) Emotional Intelligence: Why It Can Matter More Than IQ, N.Y., Bantam Books. Drawing from LeDoux’s research, Goleman uses term “amygdala hijack” to describe hair-trigger emotional responses, esp. fear and anxiety.

(3) Klohnen, E. C., & John, O. P. (1998). Working models of attachment: A theory-based prototype approach. In: J.A. Simpson & W.S. Rholes (Eds.), Attachment theory and close relationships (pp. 115-140). New York: Guilford Press.

(4) Tatkin, S. (2018), We Do: Saying Yes to a Relationship of Depth, True Connection, and Enduring Love, Sounds True, Boulder, Colo. )

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