PACT Level 2 Therapist
It was always delightful to listen to my dad, a professor of music, talk about his passion for music. His face would light up, his voice would boom, and I was mesmerized. At those times, I felt as if he was handing down the most treasured lessons of his field to the next generation. One of those lessons that found particular resonance in my life and work was his enthusiastic explanation of how to change the melody of a song.
One way to change the melody, he said, is to create subtle shifts that the audience scarcely notices at first. But then, gradually, the melody evolves into something completely different. The second way to change the melody, he explained, is to punctuate the score with a thunderous cymbal crash. That unequivocally announces to the audience that a big change is to follow. His imitation of the cymbal crash always startled me and made me laugh out loud. I loved that cymbal crash.
When I first started studying PACT, with its mix of subtle and bold interventions, I immediately thought of the lessons my dad taught me. This blog post centers on the small changes and cymbal crashes that PACT uses to shift a couple’s timeworn melody into something new and dynamic. Without fail, the combination of the therapist’s quiet and loud interventions moves the couple toward secure functioning and reveals valuable information about the dynamics of the couple during all phases of treatment.
The subtle changes begin immediately. The structure of a PACT session introduces the couple to the concepts of secure functioning, including working collaboratively and creating a supportive and safe relationship that prioritizes each other. This creates a framework and a container for what a successful relationship looks like. Each time the couple strays from the framework, the therapist’s responsibility is to bring them back.
As in a musical piece, the beauty comes from blending different instruments together, not from one person wandering off to play different parts of the score without first communicating with fellow musicians. This ongoing return to the framework of a PACT session gradually shifts a couple from cacophony to harmony. Later we will see how cymbal crash interventions can do the same.
In the initial appointment, the couple experiences the first of many subtle changes to come. The physical setup of the room has the couple sitting in chairs which face each other rather than ones that face the therapist. This establishes the expectation that they will be working with each other, not against each other.
The first appointment with couples runs for two hours. I start each session with the simple statement, “Tell me what you want out of couples therapy?” I use my eyes and ears, not to follow content, but to see who speaks first, how much they collaborate with their narrative, and how they nonverbally respond when their partner is speaking.
Then I begin my observations to the couple with the words “You both…” This is an intervention that PACT calls “going down the middle.” The intervention points out that partners are working on the relationship together and that both contribute to the security or insecurity of the relationship.
The next subtle change that I use with couples is to help them become aware of how their words, reactions, and actions affect their partners. Simple statements such as, “When you talked about your frustrations, what did you notice in your partner’s face?” These PACT techniques continue to give me feedback about each person in the couple. I often feel like a detective trying to understand why each person responds a certain way to certain patterns.
I imagine what their relationships were like with their caregivers and how their caregivers responded to their frustrations and needs. I check out my theories with simple family history questions. Helping each partner understand where certain behaviors come from creates empathy and fosters a change in the emotional tone of interactions. The melody begins to gradually change.
With some couples as the dynamic begins to show in the session, the therapist may notice that the partners seem stuck. The melody loops and loops, never evolving to new themes. At this point, a cymbal crash may be necessary.
To illustrate this cymbal crash technique, I will tell you about a couple that came to me because their interactions always ended in arguments. Bill and Marisol have been married for 10 years. They met at work and both talked about how it was love at first sight. Over time the relationship lost its way. They now spend little time together, and their sexual life is nonexistent, even though they both want sex to be part of their relationship.
Marisol was cautious and careful during the initial session, except when Bill spoke. Marisol’s face tightened; she could not restrain herself verbally or nonverbally from expressing how wrong Bill was. The old music soon began to play. They disagreed and argued fiercely. Eventually they would dismiss each other only to re-engage moments later with the same angry taunts and critiques. Both of them were more invested in the fight than the repair or the reflection about their relationship.
Although the melody was loud and out of harmony, it was their melody. With this type of dynamic, I have found that going down the middle is one of the best ways to change the melody. I wanted a cymbal crash that would move the couple toward secure functioning.
When I first studied PACT, I understood what secure functioning as a couple was intellectually, but I had difficulty knowing how to put it into practice with my couples. My PACT coach, Allison, consistently and gently reminded me that our primary goal as PACT therapists is to tailor each intervention with the goal of moving the couple toward secure functioning. It actually took me a few years to really experience what this feels like and to have the skills to guide my couples to this goal confidently.
As the fighting continued and their voices escalated, I noticed Marisol and Bill looked both miserable and oddly comfortable at the same time. I went straight down the middle: “The only way the two of you are passionate with each other is through fighting. You both have forgotten how to be passionate through love.” The room went silent. They both froze, looked at each other, and were speechless.
Often it takes more than one cymbal crash to change the melody. I added,“You both have hurt each other so much with your arguing that you only see your own hurt. Your love for each other is a faint memory.”
With a gentle voice and an open gaze, Bill said, “Marisol, I don’t want to keep hurting you. I want to love you.”
Marisol’s eyes and face softened, and she began to cry. She reached out to Bill, took his hands, and said, “And I want to love you.”
The melody had changed.
After the cymbal crash Marisol and Bill were physically and emotionally close for just a brief moment. They broke their connection and turned to look at me. I responded with compassion and stated, “Notice how quickly you let love dissipate and how much longer you keep anger going. We want to reverse this! We are going to focus on being loving. Stand up!” I directed. “Now hold each other like you will never let go.” Bill looked at me and said that they don’t do that, especially in front of people. I responded gently, “You both show me how you fight with each other, yell at each other, and hurt each other, but you don’t want to show how you love each other.”
At first, they held each other awkwardly and robotically. I repeated my instructions, this time with a friendly but firmer voice, “Hold each other like you will never let go.” Soon their bodies relaxed in the hug. They melded into each other's arms, and it was hard to see where one body ended and the other one began. Silent tears appeared on each of their faces. Tears of being seen, being held, and being adored. For the rest of the session they allowed loving words, loving touch, and loving gestures to be part of the way they interacted. They created an intimate melody that was just their own.
It is in these moments that I feel so honored to be able to witness the comfort of healing. I realize that this is just the beginning of Marisol and Bill’s treatment and that the insecure cycle of frustration and anger will repeat itself again. I also know it is my responsibility to remember this tender moment when hopelessness, inevitably, arises again for the couple. The closeness they enjoyed during the session can gradually become their new normal.
As I have improved as a PACT therapist, I have also been able to tolerate uncomfortable states much longer with clients. I avoid rescuing couples from their discomfort. I used to interrupt fighting much too early because of my own anxiety, not because of the couple’s. I learned that I needed to understand how the fighting served the couple. Was the endless conflict acting out or had they forgotten other ways to connect? If I stay calm though the process, successful interventions come more easily to me rather than being forced.
Part of the PACT therapist’s job is to be an anchor to remind a couple both verbally and nonverbally that they have the ability to change the melody of the music they have created. We can offer them the tools to help them reconnect and move toward secure functioning. Cymbal crash interventions are particularly powerful because they demonstrate on an immediate and gut level the benefit of choosing to be together. They can interrupt old and toxic cycles of communication. They show that safety, security, and a return to love is possible and that one sour note does not have to end the music.
As with the melody lessons I learned from my father, I must admit that I still favor the cymbal crashes. Their intensity just fits me. In my own long-term relationship, it took many years before I appreciated and began to love the subtle ways of showing commitment to my wife. I missed out on a great deal of love because I kept waiting for the cymbal crash. This personal lesson has helped me understand that both subtle and dramatic changes make beautiful music and are essential parts of treatment.
My goal when I see a couple is for the couple to become a committed team, a duet if you will, hellbent on recomposing the routine joyless melodies they’ve created into livelier songs that surprise and deepen with time.