The most important element in a successful couples treatment is that the clients feel safe with each other and with the therapist. The emotionally difficult work that they will be called upon to do in treatment cannot happen unless safety is guaranteed.
What do I mean by safety? First, the partners must agree to be physically safe with each other in order to proceed with treatment. If physical violence or threats of violence have been an issue in their relationship, they must make a commitment to the therapist and to each other that physical safety will be maintained. If they cannot do this, no couples treatment can happen. I have treated couples who had a history of physical violence, and they were always able to maintain physical safety in order to make the treatment successful. If a couple genuinely wants to keep their marriage (or long-term commitment), they can do this.
Beyond the requirement that both partners are physically safe with each other, they must experience having their feelings and thoughts treated with care and respect by everyone in the room. Even though their troubles may be presented in a manner that pulls the therapist toward judging one of the partners as the “perpetrator”, “bad guy”, “sick one”, “innocent victim”, or any other number of labels that are one-sided, the therapist must always view the dynamics of the couple as being equally generated by both partners. There should never be any taking sides. This behavior from the therapist is very unsafe and destructive to the treatment.
Neurodynamic Couples Therapy is based on the assumption that both partners’ brains have equally contributed to the unpleasant patterns they have developed with each other, so the atmosphere that the therapist sets in treatment must reflect that position. Furthermore, the fact that both partners’ brains are equally involved in their dramatic interactions with each other dictates that the therapist should not see one partner at a time. It is the relationship that is being treated. Seeing one partner without the other is not safe to the nonconscious and conscious minds of both, even though your clients may tell you that they are fine with being seen separately.
Having sessions with only one half of the couple is succumbing to the pressure of the power of the feelings that are being experienced by all in the room when they are together. It is also a message to the couple that you are willing to hear information from one of them that is not going to be shared with both and that you may be in the process of developing a conceptualization of their troubles as being one partner’s “fault”.
Safety requires that both partners must be seen at every session and that their troubles are seen within a framework of equal vulnerability and equal responsibility.
Next post: I will discuss more about how to conduct a safe couples treatment.