Healthy Relationships

Jim, you are an EFT Therapist giving a talk about evidenced-based therapy relationships across models, I’m confused?

That makes sense; I’m often confused myself! It’s a good place to be as a therapist at times--confusion can lead to curiosity.  Curiosity is one of the key elements of effective, engaging therapy. That sense in the room of, “what is happening here? What keeps this couple, this family, or this individual, from their goal?” This is something to explore daily in our work with our clients. Using EFT works for me as a clinician and most of my couples.  There are different approaches, it is how we engage relationally that is key.

Does evidenced-based relationship replace evidenced-based models?

That is a powerful question that we will be exploring at the workshop on November 4^th (http://denverfamilyinstitute.org/about-us/events/). We know there are common factors that  work across models. We also see the growth of “evidenced-based therapies.” How is a therapist to make sense of this? We will explore it on the 4th. I think the answer lies in what I call ACT. When a model allows us to come from an Authentic, Compassionate and Transparent place, then the model or approach is a benefit for us and for our clients. Models that constrain our ability to do this cause us to show up as awkward, critical, or tense, in turn shortchanging our clients. You know that 83% of therapists believe they are above-average therapists!

Do you think many of us are shortchanging our clients in therapy?

I would agree with Duncan and Miller and their research showing that many therapists live in the mediocre or average middle in the bell curve of therapist effectiveness. Who would want to go see an “ok” heart specialist or cancer doctor? Would you take car to an “ok” mechanic when there is an excellent mechanic next door? It is natural that we as therapists (I include myself) often overrate our abilities. We shortchange our clients when we get too comfortable. Think about it, we are field that says, “don’t work harder than your clients.” In times of doubt or fear, our clients may need to draw on our courage and our compassion. That’s where EBR’s come in.

Tell us about EBR’s, Evidenced- Based Relationships?

This term refers to the qualities of a therapist and a therapeutic relationship, which have as much impact, if not more, than the model or interventions a therapist is utilizing. It goes well beyond being warm and empathic. The nuances are exciting and allow us much maneuverability as therapists—there are many ways for us to make a difference in how we show up. At the workshop, we will explore the factors that make up effective therapy relationships, and then look at ways to build on the strengths we have while addressing any blind spots or areas of weakness.

This training will help therapists be the best therapists they can be; is that is your idea? Absolutely, why set your sights on anything less than being your best, on continuous quality improvement in our clinical work? I want to be a better and more effective therapist next year than I am now. My clients deserve the best.

Does this apply across culture, across orientation, or with difficult populations?

Certainly, knowing these factors and learning to ask and receive routine feedback about your work is even more essential when working across cultures or, for example, when working with youth in court-ordered treatment centers.

What therapists ought to attend this workshop?

Any of us, heck, I would be there as a participant if I were not presenting. This type of guided dialogue about what makes therapy work across models and within models is crucial to the development of the field. So often we debate models, but ignore the knowledge that already exists about showing up effectively. Anyone who wants to be a better therapist next week than they were this week, ought to attend. That’s why I spread the word about this material, because it keeps me on my toes. It keeps my work fresh.

How does this express in your own work?  I invite feedback from my clients routinely.  One of my primary goals is to get to know each couple, family, or individual and their unique experiences.  Therapy needs to be a safe place to explore our emotional, mental, spiritual, and relational lives.  Hopefully, my clients experience my genuine curiosity about those things that are working in their lives, and the obstacles to their goals and higher apsirations for connection and meaning.  When I fall short of those goals, I want people to be able to tell me.  Plus, we are partners in process.  We work together, flexing and adapting our work so that it meets their needs.  I would hope the experience me as an engaged, active therapist dedicated to working with them to achieve their goals.

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Saw this on a Facebook friend, Alicia Wrapp's status update:

"If WE love someone, tell them.
Do not be afraid to express OURSELVES
Reach out and tell someone what they mean to US
Because when WE decide that it is the right time,
... it might be too late."

This is a brilliant thought.  If more couples and families followed lived by this mantra, there would be little need for marriage and family therapists like myself.  So often, we hold back. we don't share the love or joy we are feeling when we are with those who matter most to us.  Why is this, it seems to fly in the face of reason?  How could it hurt us to share love, to tell someone how important they are to us?

Opening up and revealing love, joy, warm feelings towards another can be risky though.  I had this dicussion with Dr. Sue Johnson, developer of Emotionally Focused Couples Therapy, EFT.  We were talking about how vulnerable it can feel to tell our partner, a loved one, about our positive feelings towards them.  Joy is a feeling often associated with love, and joy can be a vulnerable emotion.

It is counter-intuitive.  One might imagine that sharing positive feelings would always be easy.  If we feel secure in our selves and our relationship, then shouting out to the world that we love someone carries no threat; we do so without hesitation.  But, if uncertainty exists about whether our boyfriend or girlfriend, spouse or partner will reciprocate the love or joy, then doubt sets in.  This could be true with friends and family members too. 

So as Alicia's quote inspires us to express openly to others how much they mean to us, do not be surprised if you find yourself hesitating a bit, cautious in your delivery of a positive message.  You are not alone.  What you might do, as a first step, is talk to your partner.  Perhaps saying something to them like, "Honey, I often have very strong positive feelings about us, about you, but it feels awkward to share them, like you might think I'm silly or too mushy..." and then see where the conversation takes you.

On the other hand, if you are able to share quite openly your affection and gratitude for a person in your life, then give yourself a pat on the back.  You have developed the powerful combination of self-assurance and relationship-security that opens doors to more sharing, more joy, and deeper connection with another person.  That is a true blessing.  As Alicia's mantra encourages us to do, keep telling them in many ways how important they are to you.  It is a real blessing in life to express our affection out loud in words, in affectionate gestures, and in congruent actions! 

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Funny thing, that when we are stressed we often disconnect.  You know what I mean, the stress level goes up and we tune out.  A person comes home from work, after a stressful day, and rather than engaging with their partner or kids, they want to be left alone.

Science indicates that the exact opposite may be what we need.  Indeed, it appears that people, those closest to us, actually help us to recover from stress.  This occurs when we engage with them.  When we open up, make eye contact, and talk, share, laugh or cry together.  When we reach out to each other, hold hands, cuddle, or talk, typically we are drawn together.  It is like we are medicine for each other.  Partners can be our own personal Prozac. 

The exception is when our attempts to share are dominated by anger or frustration.  Most people struggle to stay connected when someone is angry either at life or at the listener.  Our limbic systems, the emotional brain, just does not like anger in large doses.  So, when we feel the need to vent, try to sandwich it between positive emotions.  "I'm so glad to be home, it's coming home to you that makes all that work stress bearable."  Then the listener might say, "What happened at work?"  You can tell them about the stress, then close with something like, "But when you are hear to listen and reassure me, I feel better already."  Then engage in an activity together, chop some vegetables, cook dinner. 

The space to relax will come while you dine.   Your partner will know that you care about them, and the evening will go much better.  The bonus, you will likely sleep better and be rested to face whatever challenges the day brings.

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Anyone else notice this phenomenon:  that when a person gets one of those "ah-ha's" or intuitions about needing to do something different, going in a new direction, taking on a project, etc., if we don't act on it, then it saps our energy.  I see this in my office with my coaching clients and couples all the time.  I also experience in my own life. 

When I knew in my heart that it was time to go to graduate school for example back in the day, my fear and doubts combined to result in inaction.  Though the confident, affirmative part of me knew beyond a shadow of a doubt that it was time to apply to graduate school, another side of me said, "Wait, think about it more, think about the risk, what about the cost, and what if it doesn't go well." 

In these cases, internally I'll notice a drop in energy over time.  A lethargy creeps in when I don't respond when my spirit, my heart  says, "Take the chance, go for it."  Then, as with grad school, usually I come out of it, take action and move forward.  Instantly, my energy increases. 

This happens in couples work.  Sometimes one or both partners will have a felt experience, a shift in perspective towards their partnership that is uplifting and empowering in a session.  In the safety of the therapy, a risk is taken, they reach out to their partner in a new way and they FEEL a change.  They leave the session saying, "I want to act on this."  Some come back the next week beaming or more peaceful, "We did it, I used what I learned and kept the momentum."  Other times, they come back more dejected, and we find out that fear and doubt got in the way.

So what to do with that fear and doubt?  How to move to action.  Well sometimes people can "fake it til they make it," push past fear, or think positively.  But more often, we need to go inside, look at the fear, share it, and see how it blocks us from trusting our own insights, our inuitions.  Fear overrides the part of us that is ready to take the leap, to reach out to our partner, make that career change, or take up dance lessons for the first time.  We can learn to feel the fear and share it with our partner, with a friend, with our higher power.  We can discover the empowerment of not being alone in our fear or doubt. 

That's what helped me leap in to graduate school from restaurant work...I talked to Patrice, to my brother, and to a friend, sharing my fears and doubts.  As each person listened, met me where I was, the fear abated and the part of me knowing it was time to trust my heart and take action grew stronger.  I also realized I was not alone.  By sharing fear and doubt, my support team was activated offering support and encouragement.

Have you found a way that works for you to overcome the fear when part of you knows what you want or need to do?  Can you share your fear or doubts with others, reach out for support and encouragement? 

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Jack experiences a common fear in marriage and close relationships, "If become close to you, I will lose myself."  

At least once a week in couples or family therapy, I hear this comment in session.  This sentiment, that to be connected means loss of autonomy and self is prevalent.  It occurs so often, that I wonder if it is almost a normative part of the human experience.  As we move close, we fear losing self.  

The opposite or complementary fear is often, "If I accept how you want to relate, then we will never be close."  This is the fear that our partner may never come towards us to be intimate emotionally.  This common fear drives people to pursue their partners for connection in ways that over time can be come critical, hostile and angry.  

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