Working with Challenging Couples

Uncategorized Mar 13, 2016

by Elaine G. Tuccio, LCSW, PACT faculty, Austin, TX
Email: [email protected]

Challenging couples are difficult to work with if all the therapist knows to do is referee the flow of conversation and inappropriate behaviors. PACT-trained therapists, on the other hand, have numerous therapeutic tools that can be used to move these couples toward secure functioning.

For example, the PACT therapist sees acting out in session as an opportunity for staging an intervention toward secure functioning. Our training teaches us that it is usually best to sit back and observe, as if tracking the plot in a suspenseful detective novel. Underneath the precarious nature of challenging partners’ harmful defensive behaviors a relationship is waiting to be saved. Despite appearances, couples bring lots of resources, such as healthy drives and capacities that may be hidden under years of erroneous narratives about themselves, their significant other, and the world at large. The PACT therapist speaks to these resources, not to the defenses.

How might a couple find each other and go toward a coherence that at first may feel threatening? It takes a deft touch to lead the couple in this way; even a seasoned therapist is likely to feel his or her theoretical knowledge and intervention skills are being tested. It is essential for the therapist to stay present and relational when working with challenging couples. The therapist should not have to work harder than the couple. This means making proficient use of self-regulation to engender an impenetrable therapeutic stance. Dr. Stan Tatkin writes, “In all therapeutic approaches, the therapist takes a stance that suggests his or her beliefs about where the therapy should go. This stance must be clear, coherent, and consistent if good therapy is to occur…. The PACT therapist moves partners down the tube of secure functioning.”

A common clinical error therapists make when working with primitive defenses from a partner or couple is becoming drawn into their story and into their use of these defenses in emotional attacks against each other. Forgotten or overlooked are the intentional aspects of these learned defenses for survival, and how they may show up as either running away from or running toward the other. It is important to study the moment-by-moment enactments of these defenses because that can increase understanding about how, why, and when they developed. Doing this requires steady use of PACT intervention skills so the couple can flex their tacit resources and self-correct destructive patterns in real time.

Reactive patterns of negative thoughts, feelings, and beliefs, as well a sensitivity to threat, become structured into family and couple systems and often point to transgenerational trauma. Throughout their lives, these partners have tried without much support to manage the painful symptoms of early traumatized defense systems. Couples do not expect patterns that have existed for decades to be remedied in a few sessions. Yet, in my experience with PACT, a great deal is often accomplished quite quickly.

Highly insecure partners and couples need certain attachment experiences to be able to develop essential relationship capacities for play, calm, trust, security, and touch. PACT gives them a process for moving from insecure functioning to a secure means of connection through increasing their awareness of destructive, dead-end defenses. One challenge these couples face is that they do not have a sense of their own boundaries or those of their partners. They were raised in environments where the map to a relational model of secure functioning was never laid down. They fall off the edges all the time. In these instances, the therapist needs to be ready to use acting out as an opportunity for increasing the partners’ awareness of unhealthy defense systems and for setting up secure-functioning experiences. To do this safely, it is critical that the therapist maintain a strong therapeutic stance that allows him or her to soften, shift, probe, and provide relief from these defenses.

Therapeutically, the means to success in working with challenging couples is to first understand the characteristics of secure-functioning relationships. Next is to develop and maintain a therapeutic stance that takes threats off the table and leads these partners down the path to secure functioning. My own approach includes four psychobiological expectations for the couple: safety, coherence, holding their agreements, and functioning securely. During the session, I see my job as naming, normalizing, and providing practice in each of these. For transformation and integration to occur, these must be repeated in every session, as long as the couple remains in therapy.

In sum, when we challenge couples to be makers of a secure-functioning relational map, they are pressed to navigate each other’s needs and their own primitive defense systems. Their new map charts not only the boundaries of a healthy relationship, but its topography, as well. Partners who function more securely naturally reach for one another. No one gets stranded in his or her own narrative. They feel safe in each other’s care. What the therapist may see as challenging at the start of therapy is actually the vitality partners can use to forge stronger love and commitment in previously uncharted relational territory. They leave therapy with an earned security that provides them a landing they can trust going forward.


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