CC11 Workshop 15 - “CSI” Couples Work: The Utilization of Science and Technology for Assessment and Intervention - Stan Tatkin, PsyD

Description:

This workshop focuses on the use of digital audio and video frame analysis and heart rate monitoring for gathering reliable information concerning attachment and arousal patterns within and between partners. The Psychobiological Approach to Couple Therapy® (PACT) places particular emphasis on implicit body states that drive interaction between partners. Though clinicians are trained to use their senses to pick up micro-movements and micro-expressions through the body, face, and voice, precision equipment such as digital video and biofeedback devices can often provide compelling “proof” of what the clinician sees, hears, and senses when observing partner interactions.

Educational Objectives:

1. Determine if digital video recording is appropriate to their practice and if so, will be able to select and place proper equipment for this purpose in their clinical setting.
2. Define and describe body and facial shifts and changes that reveal internal and interpersonal social-emotional information.
3. Define and differentiate heart rate from heart rate variability and how these measures become relevant for the psychobiologically-oriented couple therapist.

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

Outline:

Confidentiality and Therapist Ethics

• Emphasizes confidentiality in working with couples and the need for evidence-based, not surface-level, assessments.

• Mentions new book co-authored with Marion Solomon on psycho-biological approaches to couples therapy.

Psycho-Biological Approach (PACT) Essentials

• Focuses on implicit, somatosensory, and sensory-motor processes.

• Incorporates infant/adult attachment theory, object relations, ANS, and polyvagal theory.

• Therapist functions as a master regulator, modeling mutual regulation and face-to-face connection.

Technology in Therapy

• Addresses therapist fears of new tech; encourages use of video/audio for supervision and client feedback.

• Stresses importance of visual analysis for tracking subtle cues like micro-movements and facial expressions.

• Notes patient consent procedures and offers examples of positive outcomes using recordings.

Reading Body Language & Emotional States

• Demonstrates exercises to identify attachment styles through reflexive body responses.

• Tracks cues like shoulder tension, eye movement, pupil dilation, and breathing.

• Distinguishes between the face (emotion) and body (regulation), including the role of prosody.

Interactive Regulation and Feedback

• Emphasizes moment-to-moment tracking and real-time feedback via video.

• Encourages therapists to stay regulated themselves to help couples co-regulate.

Office Setup and Technical Tips

• Recommends minimal-distraction setups (no doors in walk paths, eye-level cameras).

• Suggests testing and borrowing equipment before buying, with a preference for Sony.

• Describes how to keep recorded material secure and out of the medical record.

Video Playback and Client Insight

• Uses immediate playback for feedback and increased client insight.

• Helps couples recognize behavior and emotional impact in real-time.

Heart Rate Variability and Vagal Tone

• Introduces HRV and vagal tone as key indicators of regulation and emotional health.

• Techniques: breathing, mindfulness, and biofeedback tools like Polar watches or Stress Eraser.

Attachment Dynamics

• Identifies avoidant and angry-resistant markers; shows earned-secure functioning via video.

• Emphasizes proximity seeking, tracking, and contact maintenance as attachment behaviors.

Integrating Digital Tools

• Promotes use of digital systems to enhance observation and intervention.

• Encourages continued therapist training and self-review using tech tools.

Biofeedback and Allostatic Load

• Defines allostatic load as the stress cost of adaptation.

• Uses biofeedback to detect subtle stress signs (e.g. skin tone, pulse).

Session Structure and Timing

• Sessions range from 2–6 hours depending on the couple’s regulation capacity.

• Stresses importance of ending sessions with couples in a regulated state.

Behavioral Observation in Session

• Urges attention to micro-behaviors like fluttering eyelids during affection.

• Promotes direct inquiry with clients to clarify meaning behind physical cues.

Training and Therapist Development

• Focuses workshops on video-based learning and psychodramatic techniques.

• Supports cross-pollination with other clinicians and emphasizes continued learning, neuroscience, and autonomic nervous system awareness.