what makes couples therapy work (part 2)
We left off with Jane and Josh. Let’s pick up there.
The problem
Both of them feel uncared for, and neither can say so in a way the other can hear.
For Josh, feeling cared for has run through sex, admiration, and shared excitement. Those have thinned out, stopped, or in some form were never there to begin with. What fills the gap is coping: drinking, pornography, sports, more hours at work. He also feels nagged by Jane’s anxious pursuit and rejected by her lack of desire. The two feed each other. The less available he is, the harder she pursues, and the harder she pursues, the more criticized he feels. Under all of it sits the feeling he cannot tolerate, which is being small, or less than.
For Jane, feeling cared for has run through being noticed and appreciated, through an even split of the domestic load, and through intimacy in the wider sense of emotional contact rather than sex alone. Those have thinned out too. Her coping: drinking, sexually charged reading, true crime podcasts, hobbies, and turning her attention toward the kids. She feels betrayed by Josh’s coping and by his absence. Under it sits anger she keeps pressed down, and the belief that she is unlovable.
So they fight about the dishes, the kids’ schedules, and the tone of a text. Those fights are the surface. Neither one can find relief or empathy from the other for what is actually happening, so the small things get charged with the weight of the big ones.
What drew them together
Josh and Jane met in college. They were drawn to each other’s looks, personalities, and shared interests, and they also felt a fit. Where Josh was strong, Jane felt short. Where Jane was strong, Josh felt short. Each experienced the other as supplying something missing.
That fit helped and hurt. It helped by generating good feeling, a sense of being completed by another person. It hurt because it let them skip the work of identifying, naming, owning, and speaking their own vulnerable needs. When a partner covers the gap, neither person has to learn where the gap is or how to close it alone.
Then life changed. Work demands, money pressure, and household logistics all went up. The old unconscious arrangement could not be sustained, and when it slipped, each of them ran into attachment pain from much earlier in life. So they coped. But coping is not adapting. It was the solution each of them worked out as a baby and a child, running again in an adult body.
Their attachment history
Both Josh and Jane had what they would call a loving childhood. Not an unhappy one. Both still carried insecure attachment, which is more common than people expect. Across normative samples, roughly a third of infants classify as insecure, so plenty of people with decent childhoods are working with it.
Attachment security gets built out of the earliest exchanges with caregivers, in the first year or two, before there is language to hold any of it. So these insecurities were never stored as thoughts. They showed up as feelings that arrived in social moments. When Josh and Jane got together, they helped each other feel secure without having to try. When that arrangement fell apart under the weight of life, the old insecurities came back into focus.
What therapy has to do
The work is to catch attachment needs as they happen in the room. Dan Siegel’s four S’s are useful shorthand: people need to feel seen, safe, and soothed, and out of those comes feeling secure. Siegel wrote that for parents and children. It carries over to adults because the need does not expire. It just gets harder to admit.
In session, that runs as a five-step sequence, repeated:
Help the person notice a vulnerable emotion while it is occurring.
Help them feel it.
Help them regulate it.
Help them speak it.
The partner it lands on receives it and responds.
Written out, that sounds…tidy. In the room it is anything but.
What it actually looks like
Josh was talking about something and Jane cut in to correct him.
We stopped the conversation there because the interruption was pointing at something underneath it. We got curious with Jane about what she was experiencing. We asked her to track her senses: what her eyes were doing, what she was hearing, what she felt inside her body. She noticed her vision had narrowed to a point, her chest was tight, and her shoulders and jaw were clenched.
We had her step out of that for a moment by finding three things in the room her eyes were drawn to. Then we went back inside and had her stay with the sensation in her chest until it shifted. It did. She took a spontaneous deep breath and the tension dropped. We waited until it was gone before moving on.
Then we asked what emotion was there. Anger.
We invited her to speak the anger to her husband. I worked to keep it bite-sized so he could take it in, and had him monitor his own sensations while she spoke. When he started moving toward emotional flooding (distracting thoughts, intensifying sensations in the gut, chest, throat, and face), we paused her and turned to helping him regulate. As he settled, he recognized how frightened he becomes when she is upset, which was not something he had ever said out loud. We stayed with that until he could say it to her.
That is one sequence out of many. It took most of a session.
When it goes the other direction
Another session went differently. Josh got quiet. Quieter than usual. His face closed and he looked disengaged. When I stopped the conversation to ask what he was experiencing, he had few words and seemed cold and distant.
Josh was in freeze. Freeze carries very high activation and shows up on the outside as the least activated thing in the room, which is why it gets read as stonewalling or not caring. What he needed was help getting his physiology moving again.
I asked him to notice three things in the room. Then three things inside. Then three more in the room. He took a deeper breath. I asked him to wiggle his toes and start some gentle movement, rocking a little side to side.
Emotion started to show. He seemed less distant and more upset. I asked whether he had a sense of what he was feeling. Shame.
I asked where the shame was living in his body. His shoulders wanted to cave, his knees wanted to pull in, and there were knots in his stomach. I asked him, if it was not overwhelming, to put his attention on the sensations in his stomach, to observe them without trying to change them, and to stay there until something shifted.
After a few minutes he looked up, more socially engaged, and said the shame had subsided. What replaced it was helplessness and sadness, close to despair.
Odd as it sounds, I took that as a good sign. He was moving out of freeze and back into what he had been feeling just before he went into it. Helpless sadness of that kind is classic attachment pain. Psychoanalysts call it anaclitic depression.
I turned to Jane and asked what it was like to watch and feel this. Her eyes were wet. She said she felt open, and strangely closer to him.
Slow is fast
Work like this is slow because the core is only reachable at that pace. Defenses get in the way without anyone deciding they should. When we do get there, we find out what was never finished and never said. When those experiences can be completed with a partner who responds well enough, something shifts in how the brain holds the original material.
Bruce Ecker’s work applying memory reconsolidation research to psychotherapy argues that the old learning does not get suppressed or outgrown. Under the right conditions it gets unlocked and revised. That is the difference between managing a pattern and being done with it, and it is why this kind of change tends to hold rather than wear off. It is also what makes future assumptions and behavior more secure.
Eventually Jane and Josh could run a whole repair sequence in session without much from me. Then the repairs started happening at home, between sessions. Topics that used to create too much friction could be handled without a therapist in the room.
They needed a little over a year of weekly work. It included hundreds of ruptures and repairs, most of them small, plus a stretch of individual therapy for each of them. Those repairs rebuilt the relationship. A smaller number of tipping moments revised the memories and expectations underneath it. They recovered the marriage and built a bond stronger than the one they started with, and the whole family got the benefit of it.
Your story
Jane and Josh are invented. Both vignettes are composites, built out of many couples I have worked with, with the identifying details changed.
The pattern is not invented. If you read the fight about the dishes and recognized your own kitchen, or read Josh going quiet and knew that face, you are not looking at something rare or broken. You are looking at two people whose oldest ways of feeling cared for stopped working at the same time.
That is workable. It takes longer than most people want it to, and it asks both people to feel things they have spent years not feeling. Not every couple who starts this work stays together. Many do, and come out with something sturdier than what they walked in with.
If you want to find out whether this kind of work fits your situation, reach out to us at aaron@analogcounseling.com.
Sources
Blatt, S. J. (2004). Experiences of Depression: Theoretical, Clinical, and Research Perspectives. American Psychological Association.
Spitz, R. A. (1946). Anaclitic depression. The Psychoanalytic Study of the Child, 2, 313–342.
van IJzendoorn, M. H., & Kroonenberg, P. M. (1988). Cross-cultural patterns of attachment: A meta-analysis of the Strange Situation. Child Development, 59(1), 147–156.
Lyons-Ruth, K., et al. (1998). Implicit relational knowing: Its role in development and psychoanalytic treatment. Infant Mental Health Journal, 19(3), 282–289.
Ecker, B. (2015). Memory reconsolidation understood and misunderstood. International Journal of Neuropsychotherapy, 3(1), 2–46.
Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the Emotional Brain. Routledge.
Lane, R. D., Ryan, L., Nadel, L., & Greenberg, L. (2015). Memory reconsolidation, emotional arousal, and the process of change in psychotherapy. Behavioral and Brain Sciences, 38, e1.
Siegel, D. J., & Bryson, T. P. (2020). The Power of Showing Up. Ballantine.
Tronick, E. Z., & Gianino, A. (1986). Interactive mismatch and repair: Challenges to the coping infant. Zero to Three, 6(3), 1–6.