CC19 Workshop 11 - Introduction to a Psychobiological Approach to Couple Therapy – Continued - Stan Tatkin, PsyD, LMFT

Description:

PACT is a non-linear, poly-theoretical approach that fuse theories of attachment, developmental neuroscience, and arousal regulation. PACT is quickly gaining a reputation for effectively treating couples typically thought of as challenging.

This two-part workshop will introduce attendees to this psychobiological model, the forensic-like techniques employed to obtain information rapidly, the skills required to quickly read and assess microexpressions and micromovements and other somatic signalling, the use of creative and sometimes outrageous interventions, how to regulate difficult partners and couples as well as oneself, how to identify and work with various presentations of insecure attachment, how to differentiate psychological defenses from neurological deficits, how to recognize and deal with partner acting out, how to get partners into a light trance, how to determine attachment organization through interview and finding somatic markers, how to work strategically and improvisationally, and how to guide partners toward secure functioning. This approach is highly effective, not for the faint of heart, yet exceeding fun! Clinical video and live demonstrations included.

Educational Objectives:

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

1. Describe three deceptive behaviors commonly seen in couple therapy.
2. Apply the beginning technique for getting partners into a light trance.
3. Detect acting out behavior when it occurs and be able to apply at least two interventions for stopping it.

Outline:

Introduction to Psychobiological Couple Therapy

• Session focuses on interventions and theory, using rolling chairs and face-to-face setup for somatic observation.

• Emphasizes importance of partner positioning and physical cues.

Cross Tracking and Interventions

• Therapist watches non-speaking partner to catch subtle reactions.

• Avoid assuming causes behind self-soothing behaviors or physical movements.

Cross Questioning and Circular Questions

• Uses Milan group’s circular questions for emotional regulation.

• Partners are asked about each other to validate knowledge and prompt reflection.

Cross Commenting and Interpretation

• Immediate feedback used to open up avoidant partners.

• Therapist adjusts based on client reactions (hot, warm, cold) to build alliance.

Down the Middle Intervention

• Strong, balanced statements address the couple as a unit.

• Goal: stop acting out and initiate joint action.

Flagging and Narrative Tracking

• Unusual behaviors flagged during stress for deeper exploration.

• Uses Paul Grice’s conversational maxims to detect inconsistencies.

Beckoning Exercise

• Partners non-verbally signal each other to study attachment and empathy.

• Close observation of facial and bodily details reveals stress and bonding issues.

Corralling and Recognition Questions

• Intense, strategic questions elicit truth and reveal misalignments.

• Used to clarify unspoken issues and reactions.

Bending Metal and Staging

• Pushes partners to make clear declarations and choices.

• Uses odd or silly actions to break old procedural memory.

Live Demonstration

• Shows how to apply cross questioning, recognition questions, and body tracking.

• Uses play to keep engagement high and uncover deeper issues.

Conflict Over Household Mess

• Speaker 7 frustrated by Speaker 8's behavior; repetitive cycle causes fights.

• Speaker 8 acknowledges discomfort and comparisons with others’ tidiness.

Building Collaboration

• Couple discusses building shared rituals and co-created solutions.

• Need for openness, joint planning, and emotional safety is emphasized.

Managing Betrayal

• Betrayer must accept victim’s anger and provide full transparency.

• Healing involves genuine remorse and approximately a year of effort.

Anger and Repair Work

• Betrayed partner may express full range of anger but must stay within fairness.

• Therapist may use psychodrama to evoke contrition and repair.

Therapy Session Structure

• Begins with a three-hour intake; follow-ups are two hours.

• Goal is to assess the system, collect relational data, and promote secure functioning.

Uncovering Ambiguous Commitment

• Pressure techniques reveal hidden agendas (e.g., one partner wants out).

• Therapist ensures all options are explored before separation is considered.

Deception and Truth Detection

• Proximity, observation, and strategic pressure used to detect lies.

• Explains how and why people deceive—to avoid loss, shame, or disapproval.

Final Remarks

• Core aim is to move couples into honest, transparent, secure-functioning relationships.

• Session ends with thanks and encouragement for applying technique.