BT16 Workshop 31 - Informal Trance Induction in Couples Therapy: Partners in Chairs - Stan Tatkin, PsyD , MFT

Description:

This first of two workshops will demonstrate the use of informal trance in couple therapy. PACT therapists use rolling chairs (office chairs) as a major therapeutic tool for both the couple and therapist in managing arousal, attention, and for inducing trance states. Attendees will learn the basic tenants of PACT and a common approach to inducing informal trance states in partners using rolling chairs. Partners go into a deeper state whereby the therapist can probe, prod, and investigate more implicit issues that plague the relationship. Attendees will view clinical video demonstrations as well as live demonstrations to further illustrate this technique.

Educational Objectives:

1. Describe the three theoretical domains of PACT.
2. Apply interventions using cross-questions, cross-interpretations, going down the middle, and bending metal.
3. Use at least two ways of getting the couple into a trance state using chairs and cross questions.
4. Assess partner capacity for contact maintenance.
5. Analyze partner response by reading the face, eyes, voice, heart rate, and body movements.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

Introduction and Setup

• Session focuses on PACT (Psychobiological Approach to Couple Therapy) and informal trance techniques.

• Speakers ask if attendees saw earlier panels and seek couples for demos.

• A couple dealing with dementia-related tragedy is selected for demonstration.

Therapeutic Focus and Techniques

• Therapist chooses to regulate the couple’s arousal instead of deepening emotional distress.

• Emphasis on touch, eye contact, humor, and shifting topics to gather reliable information.

• Goal: help couple stay engaged while exploring their relational history and coping strategies.

PACT Framework

• Integrates attachment theory, arousal regulation, neurobiology, body psychotherapy, and psychoanalysis.

• Therapists use microexpressions, posture, and tone to assess the couple’s state.

• The therapist acts like a forensic interviewer, gathering and verifying data.

Secure Functioning Defined

• Not about attachment style, but about fairness, mutual protection, and prioritizing the relationship.

• Healthy couples never threaten the relationship, repair quickly, and manage third-party interferences well.

• Therapists help couples establish systems that support safety and trust.

Therapist’s Role and Observation

• Therapist acts as observer and regulator, using body position, eye contact, and voice.

• Uses techniques like “crossing” (asking one partner about the other) and “going down the middle” (balancing power).

• Leverages visual and auditory cues to track arousal and regulation in real time.

Window of Tolerance & Subcortical Dynamics

• Therapy aims to keep couples within an optimal arousal zone.

• Therapists must help expand this window and manage dysregulated states.

• Longer sessions allow for deeper regulation and exploration.

Understanding the Brain and Inhibition

• Corpus callosum limits hemispheric “cross-talk”; defects may impact regulation (e.g., in schizophrenia).

• Therapist must recognize when clients shift into automatic, reactive states and use playful redirection.

Crossing and Confrontation Techniques

• Therapist watches the non-speaking partner for authentic reactions.

• Uses plain language and observation to bypass defenses.

• Emphasizes leveling the field and maintaining therapeutic leverage.

Empathic Synchrony and Relational Tuning

• Partners who move in synchrony (matching) show emotional attunement.

• Ventral vagal system and eye contact regulate social connection.

• Matching is a marker of relationship health.

Assessing True States and Relational Dynamics

• Therapists must dig beyond appearances to understand clients’ true states.

• Near-senses and potentially embarrassing issues are valid diagnostic tools.

• Aim is to clarify what’s real and not leave clients to assumptions.

Case Study: Misdiagnosed Memory Issue

• Wife appeared forgetful; actually had poor regulation and high misappraisal.

• Dialogue revealed husband had better regulation.

• Key insight: symptoms may reflect relational dynamics, not cognitive impairment.

Live Demo: Dan and Amy

• 28-year couple presents issues around emotional neglect and project obsession.

• Therapist tracks visual cues and emotions while guiding connection.

• Couple shares a structured “repair process” (admitting wrong, asking forgiveness, asking what’s needed).

Command vs. Request and Engagement Practice

• Therapist encourages direct commands (“Give me a hug”) over vague requests.

• Mock session helps clients practice assertiveness and engagement.

• Emotional responses emerge (e.g., eye contact evoking wedding memories).

Observing Micro-Responses for Deeper Insight

• Therapist watches skin tone, posture, voice shifts to detect inner states.

• Time and pacing are key to surfacing meaningful material.

• Goal is alliance, insight, and secure relational repair.

Health, Allostasis, and Secure Functioning

• Chronic dysregulation leads to allostatic load (stress-related physical toll).

• Secure home environments reduce stress and support long-term health.

• Therapist’s goal: help clients feel safe and bonded, not threatened.

Crisis Cases and High-Conflict Couples

• In crisis (e.g., betrayal), let couple play out dynamics to observe patterns.

• Triage early: regulate before processing deep content.

• Observe post-conflict behavior to assess relational potential.

Complex Dynamics and Family Patterns

• Some couples mirror dysfunctional parent-child dynamics (e.g., verbal violence, withdrawal).

• Therapist must assess if fear is justified and ensure safety.

• Deconstructing interaction patterns is key before deeper work.

Client Goals vs. Secure Functioning

• Therapist prioritizes secure functioning even when it conflicts with clients’ goals.

• Helps clients clarify if goals (e.g., ending masturbation) align with relationship health.

• Secure functioning is foundational; decisions follow from that stability.

Open Relationships and Polyamory

• Secure functioning possible in polyamory if agreements are mutual, fair, and upheld.

• Therapist doesn’t judge structure, only functionality and integrity.

Final Takeaways

• Therapist's role is precision-guided support toward secure functioning.

• Key tools: tracking, pacing, visual/auditory cues, crossing, loving confrontation.

• Goal: lower stress, promote fairness, and foster lasting relational safety.