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Couples Therapy

  • Healing Relationships: Schema Therapy for Couples - The modular approach

    Eckhard Roediger
    Eva Frank-Noyon

    Working with couples is a challenging and complex issue. To reduce the complexity and make the interpersonal dynamics in the therapy room manageable, based on the book “Schema therapy with couples” (DiFrancesco, C., Roediger, E., & Stevens, B. (2015). Oxford-New York: Wiley) we developed a module based, strategic approach providing the therapist with a road map to stay on track when going gets tough. The pivotal idea is to focus on the mode cycle the couple displays in the therapy room. The setting combines conjoint and individual sessions.

    The key steps are stopping the cycles, connect them with the model, access underlying hidden needs and bring them on stage for a more balanced and functional behaviour. To deepen emotional bonding we use imagery techniques and connection dialogue skills support perspective change, mutual understanding and problem solving.

    Learning objectives: We will introduce the interactional theory model, the intervention modules and the outline and first results of the ongoing couples study. The participants will get a vivid impression about the module-based approach including a video snip of a conjoint imagery rescripting session. We will do two small exercises in triads too. After the workshop, participants will be able to decide if they want to deepen their knowledge in this Schema therapy-specify.

    Target Audience: Beginners interested in understanding, how interpersonal interaction patterns (so called mode cycles) work, can be identified and changed in a goal-directed and easy-to-apply way.

  • Try a little Tenderness: how to help couples attune to build a Healthy Adult connection

    Ruth McCutcheon
    Ruth Holt

    For all couples, being able to express heart-felt tenderness is vital to deeply connecting. When such moments occur in session, these are like gold-dust for therapists and need to be capitalised upon, particularly as most couples presenting in therapy will have the Emotional Deprivation schema (Young, et al., 2003). A parent who is able to provide emotional nourishment for their child creates an intimate bond; when such moments of attunement can be facilitated between couples, this can be a key source of healing (Johnson, 2012). To be cherished by a partner gives a whole new relational experience. Therefore, attunement is especially important for individuals who have been starved of core needs for affection, warmth, openness, strength and guidance. (Lockwood and Samson, 2020). We propose strengthening a Healthy Adult way of relating in a couple via ‘Emotional Connectedness’ so that couples learn to identify and respond to core needs. Also, helping couples build ‘Meta-Awareness’ to step back and manage their coping modes (Edwards, 2022). We’ve found in our practice that key coping which can challenge emotionally deprived partners is detachment which prevents tuning into vulnerability or over-compensating and being demanding of love.

    This workshop will be highly experiential and include the following:

    1) Demonstration of an ‘Attunement Dialogue’ technique. This is a structured exercise to facilitate intimate connection in a couple.

    2) Exploring how to strengthen emotional connection between a couple via physical embodiment in terms of physical affection and sexual touch.

    3) Identifying dilemmas for couples in attuning, such as over compensatory ‘love-traps’ or ‘wooden’ expressions of love which block tenderness.

    4) Exploring how therapists Emotional Deprivation schemas may show up in helping couples attune

    Key Learning outcomes

    • Tools to target deprivation of nurture and empathy in couples

    • Demonstration of an innovative technique the ‘Attunement Dialogue’ to facilitate ‘felt’ connection.

    • Techniques to trouble shoot coping modes interfering with attunement

    • Exploring therapists schemas in working with attunement

  • What's Love Got To Do With It: How strengthening the Happy Child and Healthy

    In 2019, a study published in the Journals of Gerontology reported that 40% of married adults (1,900 surveyed) ages 57 through 85 had not engaged in sexual intercourse the previous year. In another survey, researchers found that in a group of 18,000 adults from the US, a little over 15 percent had not had sex the previous year, and 13.5 percent had not had sex for five years (Archives of Sexual Behavior, 2018). While these statistics may be surprising to the general population, it is not an unusual finding for a sex therapist. It is important to note, however, that sexless relationships per se are not viewed as a problem if the couple feels balanced and agrees that each is comfortable with the current level of intimacy. For some couples, alternative forms of intimacy, such as cuddling, holding one another, and kissing, are completely satisfying and do not leave the couple feeling imbalanced.

    The majority of couples seen in this practice have not engaged in sex for many years, and they are not comfortable with their current expression of intimacy. One such couple reported that their last experience of intercourse was 18 years prior. They continued to consult with therapists seeking a shift in their relationship because neither one of the partners was comfortable with their emotional and physical expression of love and care. In addition to evaluating the couple’s functioning, early maladaptive schemas, and maladaptive coping modes, several interventions, including Schema Therapy, helped to shift this couple’s relationship course. This case presentation includes a review of those interventions and the obstacles to intimacy that had not been sufficiently addressed in prior therapeutic experiences. Most importantly, the interventions that assisted the couple in strengthening the skills of their Healthy Adult Mode and the play capacity of their Happy Child will be highlighted.

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