Keep Knee to Knee While Mutual Eye-Gazing

for therapists joy dryer Nov 09, 2022

By Joy A Dryer, PhD

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) [1] mutual eye-gazing exercise [2]. 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. ...

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When a Couple Desires More Intimacy

By Karen Berry, PhD

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...

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How to Use IFS Parts with PACT

Dayna Mullen, MSc, R. Psych

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...

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Can Your Couples Do the Couple Huddle?

Beth O’Brien, PhD 

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...

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Why Use Hypnosis with PACT Couples?

for therapists hypnosis Mar 03, 2022

Lilian Borges, LPC 

PACT Level 3 Therapist 


     The two things I am most passionate about are hypnosis and PACT. I have been teaching hypnosis for almost 30 years and, as I am deepening my understanding of PACT, I have been  exploring ways to integrate PACT and hypnosis. I’d like to share some recent experiences from my private practice in Arizona.

     Naturalistic trances are embedded in the PACT experiential approach and interventions. The eye-gazing technique is a naturalistic hypnotic approach. An externally focused trance shows the couple’s dynamics in real time without the confusing smokescreen of verbal language. The eye fixation that eye gazing develops is a light natural trance as opposed to a more formal trance induction.

     PACT uses experiential techniques as an intervention, and assessment tools to prove a hypothesis. The therapist can observe what’s happening and ask questions about...

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Use Vocal Tones as a Container to Build Better Understanding

Alexandra Mitnick, LCSW

PACT Level 3 Therapist


Hmm. Oooh. Aaah. 

Writing a blogpost about the importance of using sounds as a technique or intervention within couples therapy is challenging. When I asked my colleagues for the best ways to describe these sounds, their replies varied: Motherese. Emotional prosody. Non-verbal bursts. These are all terms that describe non-linguistic sounds that rely on pitch, timbre, volume, stress patterns, and intonation to communicate emotion and attunement between client and therapist and, more importantly, between partners in a couple. Often, reverberations resemble those between mother and baby. The value of using these vocal tones to hold the couple within a container and move them closer toward secure functioning is potent and worth sharing.

The Importance of Vocal Tonalization     

The intention for the therapist in using sounds is two-fold. First, referencing Accelerated Experiential Dynamic Psychotherapy (AEDP),...

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Vipassana and PACT: Complementary Paths of Secure Functioning  

 by Cynthia Ropek MA, LPC

PACT Level 3


Vipassana meditation is an ancient mindfulness tradition, which focuses on insight into the causes of suffering and the path to freedom. The Psychobiological Approach to Couples Therapy® (PACT) is a multifaceted therapeutic methodology for working with couples, which integrates mindfulness as an essential skill. As a Vipassana meditation practitioner and a PACT therapist, I have grown to appreciate a natural resonance between these two disciplines that goes beyond mindfulness. They both point to similar ways of being in relationship that promote health and well-being and decrease suffering.

I’d like to share some of the natural alignments that the Vipassana tradition has with PACT and my explorations of using some of the time-tested teachings and practices of Vipassana to support myself as a PACT couple’s therapist.

Distinct Relationships with What Is

Simply stated, Vipassana meditation is a practice for being with the...

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PACT Therapy with Disorganized Couples

Amanda Moates, PhD

PACT Level 2 Therapist


Insecurely attached partners, those who operate from a one-person psychological system, tend to place “pro-self values over relationship and defend against interdependency and mutuality,” as Stan Tatkin writes in the October 2020 issue of Science of Psychotherapy.

In other words, when feeling backed against the wall, these partners will instinctively move to protect the self at the expense of their relationship, not realizing their well-being is linked. In these scenarios, both partners lose.

With an organized insecure couple, the capacity to create a therapeutic alliance with the couple therapist exists when all parties understand their roles and the purpose of the work. The therapist may notice they feel part of a team. Disorganized partners have not achieved this developmental milestone and instead operate at a much lower level. They may come to therapy seeking to work on or change their partner instead of working on the...

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Melodic Moments and Cymbal Crashes

Daniel Scrafford, LCSW

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...

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Turn-Ons and Shut-Downs: Exploring Sexuality with PACT

Caroline Russell Smith, LCSW-R

PACT Level 2 Therapist


I was voted “Most Likely to Become the Next Dr. Ruth” in my high school yearbook, but not until 16 years into my career as an individual therapist did I finally complete sex therapy certification. I had virtually no experience with couples therapy (let alone the PACT approach), but I would soon know a lot about sex! What could possibly go wrong?

I nailed my framed certified sex therapist diploma to the wall and got to work. The first three couples who sought my services were kind, collaborative souls, more reticent than fiery, whose secure functioning gifted me a false sense of clinical competence. Psychoeducation did the heavy lifting, and the couples happily headed off into the sunset with improved sexual functioning. 

My fourth couple continued chatting with each other on their way to my office from the waiting area, hardly acknowledging me, then sat on my couch (no PACT set-up then) and stared at me in stony...

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