by Karen Berry, PhD, PACT faculty, New York, NY
Email:  [email protected]

Bottom-up interventions are the bread and butter of PACT. These interventions can be simple to execute, yet powerful in their effect. For example, the therapist can ask partners to face one another, with the therapeutic intention of using eye gazing to reduce their allostatic load. Compared with habitual long, slow, top-down conversations, bottom-up interventions more readily empower the couple to use their neurological systems to affect change in the relationship.

All clinicians have seen how a couple can become reactive and operated out of conditioned responses from childhood. Their brains can register threat in nano seconds. The autonomic nervous system (ANS) moves at lightning speed in response to facial gestures, dangerous words and phrases, jerky gestures, tone and prosody, as well as general body language. PACT therapists watch moment-to-moment shifts of the ANS, implicit expressions...