PACT Level 3 Therapist
Yolanda and Miguel struggle to talk about sex. Yolanda worries that Miguel is no longer attracted to her and feels insecure, rejected, and confused. Miguel has always had a low libido and more recently has been having difficulty maintaining erections. He is embarrassed, sad, and full of shame about his lack of desire and sexual performance and often withdraws as a result. Miguel’s withdrawal only increases Yolanda’s suspicion and anxiety that he no longer wishes to be with her.
Tao and Arthur struggle to talk about sex. While deeply in love they have always had different sexual wants and desires. Upon mutual agreement, they seek sexual partners outside of their relationship to satisfy the majority of their sexual needs. As time goes on, they worry about how this sexual incompatibility (not having sex with each other) will impact their future together.
Maddox and Penelope struggle to talk about sex. He is...
PACT Level 3 Therapist
“I’m still not comfortable,” says Sam, jiggling his foot.
Sam and Sandra came to couples therapy because they can’t communicate. I start them in each session with a typical Psychobiologic Approach to Couples Therapy (PACT)  mutual eye-gazing exercise . They have just settled into their rolling chairs. I ask that they sit comfortably with their knees touching.
I tell couples to breathe deeply, focus attention on the other's face, and notice every detail. Try not to talk or touch. Sam lasts about 15 seconds and then says, “I don’t like this staring thing.”
I sit on my rolling chair between them, a few feet away. My standard poodle, Hobbes, sits statue-still next to my chair. He looks up into my eyes. I look into his.
Sandra catches our exchange. She returns her gaze to Sam’s. Her eyes well up with tears.
Sam’s eyebrows rise with a question, then collapse into a knitted frown. ...
PACT Certified Therapist
As a senior PACT clinician and sex therapist, I routinely use the PACT paradigm to work directly with couples wanting more from their sex lives. I utilize the solid container of a secure-functioning relationship where both are committed to the work of co-regulation and responsibility to help their person, yet I’ve found I need to add some additional components to get robust outcomes. I want to share the essentials that I keep in mind, that ground my case construction, so I can steer solidly in my chair.
The first component is that I prefer to talk with people about their sensuality rather than “sex.” Sexuality is just too narrow and, more importantly, it brings to mind sexual performance. Clients frequently express concerns about whether their sex organs are functioning correctly, whether or not they are orgasming or orgasming hard enough, if they are having enough sex or the right kind of sex, and if they...
By Stan Tatkin, PsyD, MFT
Originally published in Science of Psychotherapy, July 2022
As a couple therapist, I struggle with partners every day who seem primarily to follow their feelings and emotions when attempting to govern each other. These couples exist without a shared, co-created relationship architecture, ethos, purpose, or vision that would otherwise guide them. No other union would form in this manner, for people generally unionize around a common purpose and vision that binds them, focuses them, and overrides their differences.
Often people form alliances because they must for survival of all kinds — physical, economic, spiritual, psychological, and cultural. Professional entities, such as a sports team, an actor troupe, a musical group, or a business partnership form collaborations in order to gain something. Still others will create limited alliances for trade and commerce. Some workers are forced by circumstance, as in a dangerous job, to have...
I have been a therapist for over 30 years, and I can’t tell you the number of times I have heard my individual clients wonder if it’s even possible for a romantic relationship to last.
They look around and see relationships on the brink, under strain, marked by tension and dashed dreams. And if they come from a family where there was divorce or infidelity, they feel even more doubtful. It can be hard to think of a couple they look up to, learn from, or feel calmed or inspired by. They don’t see couples that give them hope. Maybe you don’t either.
We all need to see, in real life, mentor couples, couples who give us hope. One of the many things I love about PACT is that it provides a structure to grow ourselves into mentor couples. And that’s good for all of us.
I have been married for a bit longer than I have been a therapist, and my husband is also a therapist. We have a solid, happy...
PACT Level 3
Any couple's relationship can be challenging to navigate, but when one or both partners have ADHD, the usual difficulties are compounded, which can cause the couple to feel like they are lost in a maze.
The three types of ADHD are inattentive, hyperactive-impulsive, and a combination of both inattentive and hyperactive-impulsive. While every case of ADHD manifests slightly differently, here are just a few common symptoms, according to the Centers for Disease Control and Prevention:
ADHD in Adults
You might be tempted to self-diagnose with ADHD, but organizations...
PACT Level 2 Therapist
As a seasoned PACT therapist, I have used this model for over a decade to transform couple relationships. I’m intensely passionate and loyal to PACT and never thought I would even glance in the direction of another model. Internal Family Systems (IFS) is the method that eventually piqued my interest and has been able to compliment PACT with some very inspiring outcomes.
I recall a conversation with my best friend, a fellow PACT therapist, about how many roles we have to maintain: wife, mother, therapist, self. We got into a great huddle talking about our roles and how many times we feel controlled by them, as though our nervous systems are hijacked, and we are made to act as if we are nine years old again. We started to play around with language and realized that by simply speaking from parts, i.e., “A younger part of me feels abandoned when you invite other people over without asking me...
By Lee Kraemer, R.P. CTP dipl. B.A.
PACT Level 3 Therapist
Let’s address the good, the bad, and the ugly use of humor by both therapists and couples.
Most people have experienced the discomfort of being with a sniping couple at a dinner party or in a therapeutic setting.
“I’m only joking,” they say as they entertain the audience with their witty repartee after skewering their partner. Zingers, so good at weaponizing words, are amusing remarks that shoot into a conversation and wound like a sharpened arrow.
We have all encountered the couples who provide stand-up comics with inspiration, the people who publicly out their partner or back-handedly dis their partner with a comment that is insulting, disrespectful, or critical. A backhanded zinger often follows “I was only joking. Can’t you take a joke?”
Zingers and Comedians
The intention of a stand-up comedian delivering the following lines has a very different impact on...
Blair Anne Hensen, MS, LCPC, NCC
PACT Level 2 Therapist
As the daylight grows longer and temperatures get warmer, it’s time to get outside! Nature is an incredibly important part of wellness. Stepping out of our human-made worlds and into nature offers presence external to ourselves. Simply taking in the sensations — the sound of birds singing, the deep smell of a forest, the feeling of sunshine warming our skin in the spring — allows our attention to move outward.
Spending time outside as a couple has significant benefits: movement, laughter, play, presence, connection are all stress reducing effects. But sometimes getting outside for activities is stressful. It takes planning, deciding what activity to do and how long you want to be out, gathering the right gear, communicating about skills and possible risks. The list goes on.
Depending on where you live, you may face difficult elements. In Montana, where I live, the weather can change rapidly. Traveling in...
PACT Level 3 Therapist
PACT therapists help couples create what Stan Tatkin calls a couple bubble. In this relational space, each partner can be themselves and accept each other as is. The bubble is an ecosystem that fosters safety and security for partners. Once their couple bubble is established, couples may benefit from taking action to proactively solve problems by couple huddling.
Partners tend to underestimate the rewards of mutual influence. They deal with their couple problems independently without consulting their partner. In doing so, they fail to realize that their partner brings helpful insights and resources to challenges. Learning to couple huddle applies the secure-functioning principle that partners protect their relationship and workshop problems together via collaboration.
What is Couple Huddling?
When partners come together to solve a problem or reach a common goal, they are huddling. Partners can feel stuck in a pressing...