The Delicate Balancing of the Couples Therapist

Most forms of psychotherapy require that the therapist perform a “delicate balancing act” between competing forces.  Some authors refer to this skill as dialectical thinking–the ability to mentally (and emotionally) hold seemingly opposite factors in dynamic tension in service of moving a system toward higher functioning.  In Neurodynamic Couples Therapy, there are primarily three areas in which the delicate balancing of the couples therapist is required for therapeutic success.

1. Safety⇔Danger — Maintaining an atmosphere of safety in the therapist’s office is a cornerstone of effective treatment.  Both partners must feel that they are not under threat from each other or from the therapist in order for the vulnerable feelings stored in their right brains to be willing to “come out and play”.  However, if the therapist’s focus on safety leads to too much regulation of affect and behavior, the “dangerous” emotions that are usually connected to childhood traumas and being accessed through a couple’s conflicts may be stifled.  There must be sufficient tolerance for the expression of dysregulated behavior and affect for everyone in the room to viscerally experience from both partners, “This is what it’s been like to be me.”  But if the balance of safety and danger within the relationship tips toward actual physical harm, the therapist must then focus on removing threats in order for the treatment to continue.

2. Partner⇔Partner — The therapist must maintain the ability to see both partners’ contributions to their conflicts equally.  If the idea of an “identified patient” within their system begins to grow in the therapist’s conceptualizations, the couples treatment will fail.  Seemingly opposite characteristics of the partners which have often created their conflicts must be seen as necessary equal contributors to experiencing historical, unmetabolized emotions.  Both partners’ brains have chosen the perfect mate for activating those emotions and presenting the opportunity to metabolize and integrate them, so both partners’ brains must be “present” for treatment to occur.  Therefore, Neurodynamic Couples Therapy purports that seeing either partner individually unbalances the treatment.

3. Present⇔Past — When couples come to treatment, they are usually almost exclusively focused on the conflicts of the present.  In Neurodynamic Couples Therapy, the conflicts of the present are seen as a uniquely useful window into historical feelings that are waiting to be metabolized and integrated.  The couple’s experience of the present must be understood in detail in order to fully reveal which historical experiences are being exposed, but exclusive attention to the present stymies the metabolizing process.  Focusing on resolution of the current conflicts may create short-term relief, but both partners’ brains will be “looking” for another way to relive old feelings.  The reliving is happening in the present, but its purpose is to reveal the emotions from the past that are being experienced by both partners.  The competent therapist deftly moves back and forth between the present and past to stimulate understanding, empathy, and permanent integration of childhood wounds and traumas.

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