Description:
This introduction to a developmental-psychobiological approach for working with personality disordered couples will provide attendees with a powerful new method that continues to show good success. This approach focuses on a two-person psychobiological model using attachment, developmental neuroscience and arousal regulation, and moves the clinician from a conflict-content model to a deficit process model focusing on real-time enactments of dysregulation.
Educational Objectives:
*Sessions may be edited for content and to preserve confidentiality*
Outline:
Developmental-Psychobiological Approach to Difficult Couples
Couples need time to think and react without pressure; clear session timeframes help.
Goal: partners become “experts” on each other—like having an owner's manual.
Focus on identifying and soothing the few specific issues that deeply trigger each partner.
Reflective functioning (accurately guessing each other’s inner states) builds attachment and safety.
Core Issues in Couples Therapy
Deep issues often stem from early attachment injuries.
Fast repair after distress prevents long-term trauma.
Partners’ nervous systems are interconnected; one’s distress affects the other.
Successful couples reduce distress quickly; unsuccessful ones escalate and prolong it.
Nervous System Dynamics
Relationships operate as two-person regulatory systems.
Interactive regulation: partners soothe each other’s nervous systems.
State shifts—quick actions that change emotional states—are critical.
Efficient co-regulation distinguishes resilient couples.
Cultural and Environmental Influences
Culture influences arousal styles:
Low arousal couples = anxiety, somatization.
High arousal couples = expressiveness, intensity.
Primary caregiver shapes nervous system regulation; environment and genetics matter.
Face-to-face and skin-to-skin contact aid regulation.
Attachment and Autoregulation
Autoregulation: self-soothing without partner interaction.
Avoidant partners struggle to shift states without help.
Dysregulation occurs when neither can regulate the other.
Overusing time-outs leads to disconnection and poor regulation.
Therapeutic Techniques
Work with couples together, not individually.
Use humor and psychoeducation to reduce tension.
Therapist may take a parental role: stop destructive behavior, set boundaries.
Physical, in-the-moment actions model effective regulation.
Video Feedback in Therapy
Video reveals unconscious behaviors and their impact.
Playback “sobers” clients and promotes insight.
Priming: subtle cues (tone, glance) can trigger arousal and conflict.
Therapists use video as a tool for awareness and change.
Eye Contact and Physical Proximity
Eye contact and closeness regulate distress.
Distressed couples often avoid courtship or attachment distance.
Face-to-face interaction supports nervous system regulation.
Therapist encourages physical presence and gaze.
Right Hemisphere and Regulation
Right hemisphere governs nonverbal, emotional regulation.
Brief, physical gestures are more effective than talk.
Therapists model reparative actions for couples.
Fast, physical interventions create state shifts and repair.
Mindfulness and Recovery
Mindfulness improves recovery from arousal states.
Therapists guide couples through grounding and calming exercises.
HPA axis (stress system) plays a key role in emotional recovery.
Goal: faster recovery from conflict and improved emotional regulation.
Stan Tatkin, PsyD, MFT, is a clinician, researcher, teacher, and developer of A Psychobiological Approach to Couple Therapy (PACT®). He has a clinical practice in Calabasas, CA, where he has specialized for the last 15 years in working with couples and individuals who wish to be in relationships. He and his wife, Tracey Boldemann-Tatkin, developed the PACT Institute for the purpose of training other psychotherapists to use this method in their clinical practice.