You can advise the couple to retire to separate rooms. This eliminates any triggering cues and allows time for both to return to Healthy Adult functioning again. This can be set as initial homework. You can then take a close look and analyze what happened in slow motion, based on the presenting coping mode cycle.
This is a cycle that cannot work. You need to stop immediately. The card takes attention away from the partner and examines the process. If the couple starts clashing again, stop immediately, as described above, and label the mode: Did you realize how quickly you lapse into these mode cycles? You both contribute. No one can fight alone. It takes two to tango. Neither of you is fully to blame for the cycle. The cycle is the problem. No cycle—no hurting. This is our common enemy! It may be helpful to end the first session with the stop commitment described above.
In the second session, give a brief summary and then introduce the schema and mode model to increase mutual understanding.
You might make up a handout or give them a photocopy of pages from this book. From a systemic perspective, there is no doubt that behavior change in one partner induces changes in the other partner as well. The other partner will consciously or unconsciously counteract changes because those changes challenge the current balance in the system. Sometimes the partner can be indirectly involved or gradually challenged to contribute to the therapeutic process.
Here are some ideas about how this can happen: 1.
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Try various things. Very often, the previously skeptical partner usually the male will become more open after grasping the rationale of ST. It is different from what he or she might have expected of couple therapy. A final thought: therapy can help the engaged person to feel more empowered, calm and confident—useful qualities regardless of the course of the relationship. Sometimes just one person who learns how to be more consistently in Healthy Adult mode can make a difference in the relationship.
SimeoneDiFrancesco has had some people thank her for saving the marriage, even when the partner never came in! Schema therapists usually work with both partners, not only in conjoint sessions but in parallel individual sessions as well. But this is not the norm in the profession, and we expect that some therapists will have objections to this way of proceeding.
One of the strengths of ST, at least from our vantage point, is that it is questioning of what is, perhaps, routine in a search for what might be best for our clients. We would like to argue for what might be a single schema therapist working in different ways with clients. ST often combines conjoint and individual sessions. Many relationship therapists work with the couple, and refer to a different therapist if individual sessions or an individual therapy seems necessary. As a therapist, you will bond emotionally with your client.
Given all this, having two therapists involved with a couple in a crisis may tend to separate the couple. Adding separate couple therapy to two individual therapies will not solve the problem. There will be an unavoidable information gap between three therapists.
And all this is compounded when the therapies are based on different conceptual models. Also, collaboration is not easy. Communication between professionals can quickly become messy or competitive. Yet the success of treatment for the couple often depends on effective cooperation.
So we will try to provide some ideas on how to best work it out. Stick to your conceptualization, be patient with the other therapist, and remain open to reality testing. Difference in perspective is often helpful. Alternatively, avoid going into Compliant Surrender mode. You will need to have an agreement with the couple to charge for time spent in collaboration.
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Without proper reimbursement, the process can become too burdensome in your practice and you may begin to unconsciously avoid spending sufficient time collaborating or develop underlying anger towards the couple. Discuss and adjust the pace of the collaboration as you go along. Have signed informed consent to disclose information between all parties. Do identify troublesome coping behaviors and recognize that the other therapist may not know what their client is actually doing, but only what the client is able to articulate and report about themselves. Therapy Tip: We think it is best to have a single schema therapist involved at all levels of working with a couple.
One approach has the best chance of shifting child, parent, and coping modes into Healthy Adult. Usually it is best to see the couple together.
Initially, you will probably ask them fill out informed consent documents. This will be solely at your discretion. Make sure that you have signed releases of information between the partners which allow you to get the information needed to treat them. This still allows you to withhold damaging material, but it leaves that to your discretion.
If you want to deliver inventory results, schema profiles, schema mode inventories or similar results, we suggest that you meet individually first with the person who has taken the test. Let the person absorb the results, and check whether they are ready to share their results with the partner. Caution: Watch out for making one party vulnerable when the other person has yet to learn empathy. Therapy should not be so overwhelmingly adverse because of abusive interactions or unrestrained rage that one of the couple does not want to return.
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You might then decide how useful the partner is able to be at that point. Reflect: In the case of infidelity, you might consider more joint sessions to encourage a sense of transparency and trust. Treat each individually while still addressing the cycle. Work to heal the trauma. Treat the mode of the perpetrator. Do your best to ensure safety. Judge when the victim is ready to reinvest in couple therapy.
Often, one partner will call about relationship issues, but their partner may not be willing to come.
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Sometimes they want to get a perspective in first. It may be wise to try to understand the agenda of the caller. During the first visit, formulate your own opinion about whether it is a good idea for the partner to come in soon. Sometimes it is clear that the first party needs to deal with something first, and for the partner to remain open and trusting about joining up later.
This is usually a good indicator for a positive outcome. At the point when it becomes clear that you can work with the couple on their relationship with sufficient safety, you can shift to couple work. Some couples will want mode work and imagery shared in a session with their partner.
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This can be a powerful source of emotional reconnection. Others feel too vulnerable and need the safety of an individual session to reveal their basic emotions and core needs. So it is best to go slowly and with caution. The session must remain safe. Work from your case conceptualization. Ultimately, this will assist each to feel more secure and hopeful, and lead to more effective treatment. Warning: Some clients are so overcompensating that they refuse to give the therapist permission to work in a flexible way.
At times, it is not practical to have one partner sit through a session when 99 percent of your attention is focused on the partner. At other times, it is useful to develop empathy by having one partner relive as you do trauma work with the other, and the partner may actually help out, come into an imagery scene, and comfort and protect. Make these therapeutic judgments as you plan the next session or two, and then you can schedule accordingly. Sometimes it is helpful to have the partner on hand, in the waiting room, so you can bring them into a session if needed.
Some people will not mind being available in this way. People cannot allow themselves to be dehumanized and destroyed. Allowing harm to continue cannot possibly be healthy or moral. Use every point of leverage to shake up or change a harmful relationship. Although the path is complex, many harmful states can be abated and healed, given goodwill and effort. Some challenging issues can present, such as an affair, different motivations to engage in therapy, and unrealistic expectations. If you are working with the couple, then some basic commitments that prioritize the relationship and limit destructive interactions are important.
Sometimes you will only have one person presenting to address couple issues, and therapy will have to adapt. It is important to adopt an ST perspective from the start of couple therapy and to begin to notice what you will need to develop a case conceptualization.