Final Flashcards
Challenge of Couples Therapy
• Stakes are high • Volatility • Escalation • Blaming each other • Secrets • Taking sides Therapists tend to be empathetic, compassionate, calm, accepting
Myths about Couples Therapy
- The goal of couples therapy is to “fix” the other person
- If this relationship was “meant to be” we wouldn’t need couples therapy
- Couples therapists decide who’s to blame for the problems in this relationship (we take sides)
- Couples therapy means it’s too late
- Couples therapy means we have to dig up old stuff
- Couples therapy will make things worse
- Couples therapy always aims to keep the couple together
- Couples therapy will take forever
- Individual growth (and healing) can only occur in individual therapy, not in couples therapy
Beginner’s mistakes
Lack of Structure
Misaligned goals
No plan for change
Giving up
Emergence of Couples Therapy as a unit of treatment
- As mental health intervention (unique unit of treatment)
• Research links quality of intimate relationships to
individual physical and psychological well-being
• Negative impact of divorce on couples, families,
children communities
• Less community; more dependence on intimate partner
for support/connection
> Recognizing as functional communities of two - New research in the neurobiology of relationships
- The emergence of concept of “adult love” (attachment)
• Quality of closest relationship determines quality of life
Premarital Counseling Benefits
Couples who participate in premarital education
and counseling have 30% lower divorce rates
Helping couples create a lasting, strong relationship
foundation
• Identify relationship strengths & growth areas
> Use strengths to improve
• Build a relationship foundation
> Strong, healthy communication skills
> Culture of connection
• Relationship with therapist
> Overcome stigma; more likely to reach for help
when trouble shows up
Premarital Counseling non-negotiables
• Relationship expectations can be negotiable or
non-negotiable
• Communicating about this beforehand can:
> Lead to creating shared goals
> Avoid disappointment and issues within the
marriage
> Will differ from couple to couple
Nurturant Solace
We do better in relationships than out of them
Helen Fisher; anatomy of love
> More than an emotion
Leading expert on the biology of love and attraction
• Research on the chemistry and brain circuitry of love
> All humans have reproductive strategies in common
> Most referenced scholar in love research community
Falling in love (stages)
3 stages of love1 1. Lust • Sex hormones: testosterone, estrogen • Evolved to motivate sexual union with almost any semi-appropriate partner 2. Romantic Attraction • Neurotransmitters: dopamine, norepinephrine, serotonin • Evolved to drive focus on one partner to conserve courtship time/energy 3. Attachment • Hormones: oxytocin, vasopressin3
The Cuddle Hormone
Oxytocin
Released when we snuggle, hug, bond socially
• Childbirth, breast-feeding
• Empathy, trust, sexual
activity, relationshipbuilding (connection)
• Possibly related to
depression, anxiety,
intestinal problems
• Higher levels in females than males
• Even playing with your dog can release oxytocin
Rejection Stages
- Protest
• Overcome by sadness, longing and nostalgia
• Difficulty sleeping, changes in appetite
• Longing loved one
• Take measures to reconnect with partner - Resignation/Despair
• Sadness and depression
• Gender differences in the manifestation of this
Mirror Neurons
• Neurons that fire both
when an animal acts
and when the animal
observes the same action
performed by another
• Neuron is said to “mirror” the behavior of the other,
as though the animal performed the movement itself
IPNB (Interpersonal neurobiology)
An interdisciplinary field that brings together many areas of
science (such as anthropology, biology, linguistics,
mathematics, physics, psychology, etc.) to determine
common findings of the human experience
• Purpose to create a common definition of the human
mind and determine what it needs for maximum health
IPNB Relational Theory
Key is reciprocity
• Feeling seen and heard, and being able to feel, see,
and hear others1
Feeling as though someone is holding us in their
heart and mind (connection)2
• If we have this and if we learn to tap into it under
stress/ duress, we can regulate3
> For physiology to slow down, heal, grow, we
need that felt sense of safety
Embodied Relationality
o Interpersonal Resonance & Mutual Regulation
**SHORT ANSWER
Two primary facts about human beings:
• We are embodied (self) and in relationship
> To be alive, we need to be a body and we need to
relate to others
> Presents our greatest challenges and our greatest joys
• Interpersonal Resonance1
> Two or more minds align their states and become
mutually influenced by one another
• Mutual Regulation
> Bilateral influence of 2 people on each other’s
coordination and balance of internal states
IPNB Role of Integration
Our capacity for internal integration initially derived from
early attachment relationships
Tension of Opposites
**SHORT ANSWER
• Key to the work of healing/growth • Differences in how each partner responds to conflict Two main categories • Minimizing or Maximizing > In general: Minimizers and Maximizers > Imago: Turtles and Hailstorms > EFCT: Withdrawers and Pursuers
Attachment
A deep and enduring emotional bond that connects one
person to another across time and space
Attachment process
Responsible for the development of affective system
• Emerges from (and influences future of) relationships
• Determines whether person has general sense of security
or insecurity in the world (and in relationships)
> Security is an internal sense of being able to count on
others for healthy interdependence
> This becomes an internal working model for how one
perceives others in the world (safe or unsafe)
• First signs of attachment at 6 mos (probably in utero)
Limbic Resonance (Interpersonal Resonance)
Our nervous systems are affected by those closest to us
(mirror)
• Our brains synchronize with our closest relationships
> Profound implications for personality and lifelong
well-being
Limbic Revision
Therapeutic intervention can modify these patterns
Primary Attachment Question
**SHORT ANSWER
Is there an attachment figure that is sufficiently
near, attentive, and responsive?
• If answer is generally and consistently YES
> Person feels loved, cared for, seen, confident
— Free to explore environment, interact with others
— less inhibited; interest in exploration
— generally happy, content
If answer is consistently “no”
• Continued attempts to draw attachment figure back
become exaggerated
> Hope that increasing intensity will make it happen
(like gambler and slot machine)
> Becomes preoccupied or hypervigilant with attachment
figure’s availability
• When caregiver continually fails to respond appropriately,
eventually leads to detachment
> Human mind is capable of deactivating or suppressing
its attachment system (to a degree)
> Turns to self-reliance
Attachment and Human Relationships
What does attachment theory tell us about the
role of relationships in what it means to be human?
1. Seeking and maintaining contact with a significant other
is inherent to being human
2. Fear of isolation is inherently traumatizing
3. Life stressors automatically activate attachment
responses
4. Separation from our significant other(s) creates
predictable and automatic stress responses
Adult Attachment (Romantic) Relationships
Earliest caregivers don’t only feed us, etc.
> Shape how growing brain perceives reality/the world1
• Creates internalized maps (Limbic maps): beliefs about
self & the world
> Maps remarkably stable over time
> Maps shape our perception of others; our ability to
perceive relationships2
Adult Romantic Relationships
20
We enter adult relationships highly influenced
by early attachment experiences
• Adult attachment relationships determine our ability to
make sense of our adult lives
Adult Attachment types (based on childhood attachment types)
SECURE –> SECURE
AVOIDANT –> DISMISSIVE
AMBIVALENT/RESISTANT –> PREOCCUPIED
Dependency Paradox
***SHORT ANSWER
We can be independent only when we have someone to
depend on
Single Physiological Unit
**SHORT ANSWER
• In an attached adult relationship, we can control each
others’ physiology or level of arousal
> Synchronized blood pressure, breathing, heart rate,
breathing hormones
• We can teach couples to regulate themselves and each
other!
Attachment Triggers (3 main types)
Three main types of triggers (for attachment)
1. Conditions of self
• Fatigue, hunger, illness, pain, etc.
2. Conditions of attachment figure
• Absent (extended or emotionally), “leaving,” rejecting,
giving attention to another, etc.)
3. Conditions of the environment
• Alarming events, criticism or rejection by others, etc.
