Practice Management
Labor Day Announcement
In reference to Labor Day, please be sure to begin informing your clients that on Labor Day, Monday Sept. 6th the MCO office will be closed. With that being said, If your client is scheduled with you on Tuesday, Sept.7th and needs to cancel, they must call the receptionist team no later than Friday, Sept 3rd by 5 pm CST to prevent any unwanted fees because the office will not be open on Monday. Here at MCO we value our client’s and clinician’s time so please help us inform our clients.
Just so you are aware, we are also putting an announcement on our website, our social media and our phone system to properly communicate and prevent any unwanted fees or scheduling issues.
With Gratitude,
Rosaria Z.Gillis
Experience Advocate of MCO
Pre-Didactic Material
EFT w. Highly Escalated Couples
Introduction
There is nothing more dysregulating for an emotionally responsive therapist, trained in the art of vulnerability and connection, than a reactive couple, shouting and yelling in our sessions, talking over each other, and hurling insults at each other right before our eyes. We long to help our couples connect but there seems to be so much in the way. Perhaps you respond to this reactivity by getting frustrated with the clients and losing empathy. Perhaps you feel anxious and insecure, not knowing what to do or how to move forward. Or perhaps your feel helpless and lose your own strength, succumbing to the intensity of the couple. We all have our reasons for becoming a therapist, and for many of us, this came from having a naturally empathetic disposition, and playing the role of peacekeeper in our homes of varying levels of dysfunction.
Person of the Therapist
Before we begin, take about 15 minutes to feel into your relationship with anger by asking yourself the following questions:
- Check in with your own inner child. How does he/she feel in the presence of anger? How does he/she respond to it? Does he or she feel permission to engage her/his own anger? What happens when he/she does?
- Ask these same questions to your teenager and your young adult (if applicable).
- What is your relationship like with anger now? What feelings do you notice that accompany it as it rises within you? Guilt? Fear? Sadness? Disgust? What feelings accompany it when the anger comes from others?
- Get to know your own anger: The next time you feel angry in your romantic relationship (if applicable), notice how it feels in your body. What is the anger trying to do or accomplish (i.e., it’s function)? Notice how it makes you feel. Notice the quality of it: the temperature, energy, sensation of it. Is there an image that could symbolize your anger? (Mine began as a fireball 🙂 As you understand it, can you befriend it by turning kindness and compassion toward it? Notice how it shifts when you do.
- Share something about this experience with a safe other, i.e. a trusted friend, colleague, therapist, family member, etc.
Reactivity and Secondary Emotion Through An Attachment Lens
Now that you have understood and befriended your anger, let us examine anger through an attachment lens. Remember that “emotion organizes actions toward others, and emotional signals set up and constrain the actions of others to the self. These signals also set up habitual interaction patterns or “dances,“ that then feedback into and frame the experience of each of the dancers. Each emotion is linked to a discernible action tendency. So anger is an approach emotion that sets up the assertion of needs and the removal of blocks to satisfaction…(Johnson, 2019).” In other words, emotions link us to our needs, and then drive action toward meeting that need and this becomes part of our dance with our partners. When we send an emotional signal to our partner, we need to know that they hear it and will respond accordingly. Like the baby in Ed Tronick’s Still Face Experiment, when we do not get responsiveness, we will panic. “Easily triggered anger and hypervigilence are likewise functional when the alternative appears to be that one is inevitably dismissed or deserted.” (Johnson, 2019)
Reread pages 40-49 of Created for Connection as a refresher on the “primal panic” which hijacks our bodies in disconnection, and the “demon dialogues” which ensue in an effort to regain connection.
These demon dialogues will play out before your eyes in session, you just need to know how to identify them. In relationships with a “Find the Bad Guy” dance of attack-attack, you may see higher levels of reactivity in the session as the two sparks are bound the start a fire. Pursuers anger is often “proximity seeking” and in their minds, any response is better than no response. Pursuers will poke by taking shots and jabs at their partners, criticizing, blaming, and accusing their partners in order to get a response and in order to stave off their worse fear of being abandoned or rejected by their partner. Withdrawers anger is usually “distance-seeking” in an attempt to get away from the tension of the relationship, calm their nervous system, and await the storm of conflict to pass. This will likely look like stonewalling, flat affect, and unresponsiveness. However, there are times when, if backed into a corner and/or enough shots are taken at them, the withdrawer will come out swinging (metaphorically) in defense of themselves. This is what is playing out in front of you in a highly reactive couple.
Role of the Therapist
Your job is to validate and understand the anger, so that you can help the partner send a clearer signal to their partner, which will elicit the response they actually want- relationship security and connection. Your stance is one of unconditional positive regard and non-judgement which will allow for safety and thereby curious exploration of the partner’s inner experience. You will need to continuously and constantly redirect your client back to their own experience (view of self), as they will likely be using blame, accusation, and criticism toward their partner (“view of other”), even when talking to you. Your goal is to organize the emotion with your client, helping them to understand what they feel and why, offering them a felt sense that they make sense. We are helping clients “name it to tame it” and moving emotional experience from chaotic and overwhelming to normal and valid. You will do this by assembling the elements of emotion, what we call TEMP elsewhere, but more technically includes the following:
- Trigger or cue
- Initial perception
- Body response
- Meaning creation
- Action tendency
However, they way you will do this is very different than in other, less reactive sessions.
Interventions for Working w/ Reactivity in Session
- Match and Drop-When working with reactive emotion in session, we are not able to use a typical “low and slow” tone, as this feels dismissive of the anger in the room, and does not match or join with the anger. As therapists, we must have several levels of energy and tone that we bring into a session, in order to best attune to our client, whatever the emotion. You may have experienced trying to contain reactivity and feeling mowed over by a freight train. This is often because we are not joining and matching the emotion to the degree that is needed. As mentioned earlier, the anger must be named, understood in it’s function and validated as response to the trigger. Therefore, the first key to working with reactivity in session, is to match the anger. We do not need to do so to the extent the partner is feeling it, but they need to feel understood by us. Remember that anger helps us to feel powerful, seen, and heard in the face of feeling ignored, dismissed, and insignificant, therefore we must show our clients with our tone, facial expression, and body language that we see, hear, and understand them. Once anger is understood in this way (named), it softens (tames), and often the softer, more vulnerable emotion beneath it will begin to emerge. We will use our own tone, attachment framing, and conjecture to lead the client into the “drop” into core emotion and attachment fears which is inevitably fueling the reactivity, usually as a fear of rejection or abandonment.
One of the primary issues in working with reactive couples, is that they often both want to speak at the same time, and continuously interrupt one another while the other is speaking, especially as you are beginning to finally get somewhere with their partner. Interruptions and Blocks, in the words of EFT Trainer George Faller, are “mistrust in action.” As we use the map of the EFT Tango to focus the session, partners will inevitable break in and, if we are not aware of where we are and where we are going, these interruptions will derail our session and prevent us from being of help to our clients.
First, determine the type of interruption using the following descriptions:
- Using Red, Yellow, & Green Lights
- Green Lights are interruptions of empathy. These are kind, encouraging, and supportive responses from the partner, which can be deepened and used to facilitate the partner you were originally working with to take greater risks and go deeper into their own vulnerability.
- Yellow Lights are interruptions that are partially empathetic, but also partially mistrusting. We will “part out” the response, close validate the “red light“ mistrust (do not explore), and privilege the positive “green light,“ asking the partner to enact this empathy (turning it into a green light). If the partner cannot stay with the empathy, and the yellow light becomes red, see next section. CPR, described below, is a great technique in working with “yellow lights” as well.
- Red Light interruptions are entirely mistrust and will likely feel like bullets (or grenades, or missiles, or bombs- think deadly) going off in the session. Determine whether the block is INTRApersonal (about self), or INTERpersonal (about other/relationship). Make your transition explicit to the partner you were working with and explain that you want to understand what is happening for the interrupting partner, but will return to them (called tying a tourniquet) and explore the block that arose.
Use CPR to maintain alliance with both partners and the focus in the session:
- CPR
- Capture the live reactivity- recognize this as an interpersonal block and emotion breaking through
- Provide permission for the action tendency – name, make sense of, understand, and validate what the partner is saying WITHOUT exploring (called a closed validation)
- Return to your original focus before the interruption
Sometimes, interruptions persist and the CPR is ineffective in resuscitating your session (pun intended). In these cases, you will have to be more direct. TERROR is a way of working with higher levels of reactivity in session.
- TERROR
- Take charge of session
- Explicitly explain intention/process
- Restrain interruptions and close validate
- Regulate affect by matching
- Organize meaning of secondary emotion
- Restore safety and bridge distance by honoring defenses
- Catching Bullets: Reactivity & Mistrust in Enactments- Sometimes, you will be able to tame reactivity and deepen the underlying emotion enough to be able to pass it in an enactment, but one or both partners will not be able to stay with the vulnerability and/or will experience mistrust of the new experience. This can happen as the enacting partner pops out of emotion and into defense or anxiety, or by the receiving partner who cannot trust what is emerging in their partner.
- When this happens for the enacting partner, we track and make this explicit with kind curiosity about “what just happened” and invite them to enact” from their hearts” and “let this part speak” to their partner.
- When this happens with the receiving partner, we will validate the mistrust, understanding why this shift is so hard to take in, and ask them to imagine if what their partner was saying is true, what would that be like (using the imaginal channel).
- Moment to Moment Tracking
- “The best defense is a good offense” and this applies to working with highly escalated couples as well. If you are connected and attuned to your clients, you may be able to read facial expressions and body language which would cue you into what is happening in their internal world far before it erupts into reactivity. Remember that by tracking both partners closely, you are able to read them, and move toward emotion with curiosity and compassion before it overtakes your client and pops them outside of their window of tolerance. If one partner is escalated, it will often cause reactivity in your session, so be sure to continue redirecting an escalated partner back to their own experience in order to catch bullets and facilitate emotional regulation and meaning-making.
Conclusion
My goal in this didactic is to help you to maintain a sense of balance in your reactive sessions, both by better understanding your own internal responses, as well as giving you tools to use in these moments when emotions are high and cause you to feel disoriented. I encourage you to take the tools and use them, practicing with and sharpening them as you go. I am here to support you each step of the way, and am right here growing alongside you. Go Team MCO!