Avoiding the Identified Patient ...
Early in the development of family therapy theory, authors used the term “identified patient” to describe the family member whose behavior brings a family into treatment. This is usually one of the children, but not always. It is the person who has acted out enough to cause the parents to seek help or to get […]
Reframing Repetition Compulsion
As students, those of us who were pursuing a career as psychodynamic psychotherapists learned about the repetition compulsion. The Oxford Reference (www.oxfordreference.com) defines this phenomenon as “a tendency to place oneself in dangerous or distressing situations that repeat similar experiences from the past.” Webster’s Seventh New Collegiate Dictionary describes a compulsion as “an irresistible impulse […]
The Perfect Language of Couples ...
All psychotherapists know the importance of language. We pay close attention to exactly what our clients say and how they say it. In this post, I will share a case that illustrates how the perfect language of couples’ complaints provide the roadmap for their treatment. The wife begins a session: “I can’t stop being angry at him. […]
The Neurobiopsychological Mechan...
Most forms of couples therapy are focused on resolving conflicts in the present-day lives of couples who seek treatment. Some methods do delve into the historical antecedents of those conflicts, but their primary goal remains helping couples meet their current needs. Neurodynamic Couples Therapy is based on the belief that the intractable, chronically unresolved conflicts […]
The Delicate Balancing of the Co...
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 […]
The Difference Between Hurt and ...
A frequent complaint that therapists hear from couples when they enter treatment is that they have felt hurt by each other. They want to tell us all about the pain that their partner has inflicted on them, and they often seem to want the therapist to declare which one of them has been the “most” […]
Reliving Rage
What is rage? My sweet little cairn terrier taught me what rage is. One day I put down her feeding bowl, and she started her meal. I needed to move the bowl slightly to get it out of my way. As I reached my hand down toward her bowl, she bit me! She had never […]
Reliving Terror
At the end of my last post, I wrote about the shame connected to childhood abuse that must be relived in couple relationships. Couples in which one or both partners were victims of childhood abuse will likely also be reliving terror. Terror is the feeling that leads to a flight or freeze response. The victim experiences […]
Reliving Shame
Because the emotion of shame usually derives from having done something “wrong” in the eyes of significant others, it is inevitably part of every important relationship. That look of disapproval or disgust that accompanies shame-filled experiences is such a blow to our self-esteem that creates so much subjective pain; it is no wonder we avoid […]
The Dysregulated Emotions of Tra...
When couples come to us for treatment, they have frequently been struggling with the dysregulated emotions of trauma. Their right brains have been correctly mutually creating an outlet for these unmetabolized emotions through their recycling dramas, but the partners usually do not know what to do with them and have almost always developed a sizable amount […]