By Rachel Holland, DClinPsych,
PACT core faculty
Buckinghamshire, UK
[email protected]

Dan and Jane have been married for thirty years and have three sons. They came into therapy following a challenging time in their lives after they faced a number of health, family, and work problems in quick succession. Jane had also suffered a recent traumatic event and was struggling with posttraumatic hyperarousal. She was sensitive to noise and crowds and felt that nowhere was safe anymore. Both Dan and Jane were distressed and looked exhausted in response to these events. Their relationship had become adversarial and verbally aggressive, and they felt like they were “on eggshells” with each other. Both were seeing individual therapists for support, as well as seeking couple therapy.

My initial ideas about this couple included issues related to allostatic load (i.e., the cumulative burden on the nervous system from multiple chronic stressors; McEwen & Seeman,...

by Rachel Holland, DClinPsych, PACT faculty, Buckinghamshire, UK
Email: [email protected]

One of the characteristics of secure functioning a PACT therapist communicates is that romantic couples, as the King and Queen of their domain, protect their relationship and each other in public and in private.

I had been working with Peter and Jane for four sessions. They came to therapy for help with intimacy, and our initial work focused on therapeutic alliance and social contracting. Both were outsourcing their arousal regulation away from the relationship to substances.

From the Partner Attachment Inventory (PAI), I knew both Peter and Jane experienced emotional neglect in childhood. They had parents and caregivers who were either unavailable and didn’t protect them sufficiently or behaved in ways that were frightening. More importantly, the couple now had this information about each other and a better understanding about how each operated. They were beginning to...