Consider These Ten Strategies
Survival states of mind
Couples get emotionally dysregulated in a session fairly often. Couples therapists who work with dysregulated couples can lose empathy and can become dysregulated themselves. So it’s important for the therapist to have a set of strategies at their fingertips. What can you do, as the couples therapist, to help partners bring their “higher brains” back online?
Self-regulation and co-regulation are important activities for counselors who work with couples to learn. The couples therapist can explain to the clients that “no productive conversation will take place when you are dysregulated and in ‘lower brain’ mode”.
Counselors can plan interventions in advance, based on what they know about the couple, so they are ready when they observe certain behaviors that indicate that the couple has entered a survival mind state. If the couple agrees to practice some of these strategies during a session, they are most likely to transfer that habit into their own lives outside of the sessions.
Self-Regulation or Co-Regulation?
When couples become adversarial, combative, or withdrawn during a session, they have entered a survival state of mind.
There are various ways to increase self-regulation and co-regulation. An attachment-oriented counselor may be more inclined to encourage co-regulation while those who put more weight on the value of differentiation may be more inclined to emphasize self-regulation. Both are important. What follows are 5 strategies to help couples with co-regulation and 5 strategies for self-regulation.
5 Strategies to Help Couples Co-Regulate
The need for comforting words, gestures, or touch does not end with childhood. The increased ability to soothe a partner with words of comfort, gestures, or touch lowers stress hormones, helps to emotionally regulate a partner.
1. Soothing partner with words
“I’ll take care of it”, “I care about you”, “I am here for you”, “I love you, everything will be ok”, “I hear you”, are all examples of soothing words that help to regulate partners.
Counselors can guide partners to discuss what words would be soothing to each and help them practice during a session.
2. Soothing partner with presence
When couples first meet and fall in love, they spend a lot of time paying attention to each other, they do fun things, they ask a lot of questions of each other and they spend time together with no screens.
Sometimes, a couples counseling session is the only time that the couple is in the same room without looking at screens talking about themselves, their partner or their relationship.
Help a couple create the habit of a “no-screen” meeting during a session. Avoid talking only about problems, disagreements and disappointments during a session. Do sentence completion exercises or help them come up with questions to get to know their partner better. Encourage and practice verbal gratitude and compliments.
3. Soothing partner with re-entry rituals and greetings
In the beginning of their relationship, couples greet each other with intention upon re-entry after a separation, and some check in with each other during times of daily separation. Much of the distress and dysregulation can be explained by how couples deal with daily separations, and whether they have intentional re-entry rituals. Spend time in a session helping them design re-entry rituals and greetings after daily separations or travel and practice it during a session.
4. Soothing partner with eye contact
Eye contact decreases stress hormones and lower brain activity. Looking into the partner’s eyes implies care, empathy and connection. Sustaining the gaze is not an easy activity for some people. Practicing eye contact during a session can prime a couple for a new habit. Counselors can instruct couples who are talking to each other to do so while looking intently in the eyes of their partner.
5. Soothing partner with touch
Touch deprivation is an important aspect that explains dysregulated states. Lack of touch increases stress hormones, affects the immune system, and general mood. Mood irritability can be the cause or the effect of touch deprivation, creating a vicious cycle. Physical touch and erotic activity are two distinct processes, but sometimes, they get comingled, leading to further disconnection. During a session, therapists can guide couples to engage in touch activities to lower the arousal: Counselors can ask couples to touch their partners knees, hold hands, or even just hold a finger. Then, couples can move on to touch each other’s face, hair, put a head on the partners’ shoulder, or try a long, body to body hug. The more practice they do during a session, the more likely they are to try it at home.
5 Strategies to Help Couples with Self-regulation
Couples counselors can recommend a variety of tools including mindfulness, imagery, a gratitude stance, meditation, breathing, or body scans they find soothing to clients. Clients who learn to self-soothe in session, will become more able to create the habit of self-soothing between sessions.
1. Setting an intention for the session
It’s important to help clients get grounded in a session by setting an intention that reflects their values: “What do I want to learn about myself today?”, “How do I want my partner to feel when I bring up a difficult subject?”, “What kind of partner do I want to be?” are ways to set an intention for a session and have the potential to prevent lower brain activation. You can remind them or their stated intention if they get dysregulated.
2. Body scans
Directing awareness to the part of the body while breathing can be a powerful way to increase emotional self-awareness and integration that may lead to self-soothing.
3. Gratitude rituals
Along with setting an intention for the session, clients can be encouraged to verbalize gratitude at the beginning or at the end of a session. This is to shift the attention from “What I don’t have and want to get”, which has a negative connotation, to the more positive: “I am grateful for what I do have”. Gratitude can be self soothing, in addition to soothing the partner in that it prompts a “glass half full” attitude and can be instrumental in lowering resentments.
4. Cultivate a “revision” practice
You can ask couples to start to cultivate a “revision” practice in the session: To create a space between the action and the feeling that precedes it. Counselors can direct clients to think of their first thoughts and feelings that come to their mind as the first draft. A first draft always needs revisions. It’s important to teach clients to tolerate their own negative emotions, so they can slow down the delivery of the words, for the prefrontal cortex to come back online. When clients begin to cultivate a “revision practice,” they can think of their initial reaction as the draft of a paper. When they revise, they can make space for alternative thoughts and feelings and they can figure out what to say, when, and how. When clients revise their draft, keeping in mind the impact what they say has on their partner, what they end up saying becomes clearer, better, and kinder.
5. Talk to the counselor and not to each other
Sometimes, counselors need to help couples create the habit of the “revision” practice above. To further help couples make a connection between what they feel and how they act, we can teach partners to pause and reflect on their feelings, and then ask them to think about how they want to convey their feelings to the partner in the session. Therapists can encourage clients to talk to them first, instead of to each other, and only after they have some clarity about what they want to say, the therapist can encourage partners to talk to each other.
No single intervention is effective for every couple at every stage of the treatment process, so couples therapists are encouraged to create this repertoire of strategies with the couples’ permission and collaboration.