Our picture of the ideal therapeutic stance—the proper way to relate to clients—emerges out of our particular theory of the problem and plan of cure.
Classical psychoanalysis sees the curative factor as arising out of the analysand’s projection upon the analyst of crucial unresolved relationship issues from childhood. The proper therapeutic stance, accordingly, is to serve as a blank screen in order to allow the unimpeded and undistorted development of this transference.
These days most therapists adopt some combination of what can be called the educational and corrective-emotional-experience stances.
In the educational stance, the psychological problem is attributed to clients’:
- Skills, knowledge, or developmental deficits
- Bad habits or inadequately controlled emotional reactivity
- Faulty beliefs—the black-and-white thinking, perfectionistic standards, and negative self-talk of cognitive behavior therapy; the pathology-saturated self-narratives of narrative therapy
- Failure to recognize how their response to people in their present life is influenced by unresolved feelings toward people in their past
The appropriate role for the therapist, accordingly, is that of educator or re-educator. We function as kind of teacher, coach, trainer, expert, doctor, cheerleader, guide, interpreter, co-creator of the client’s reality, questioner of the client’s beliefs, model for the client to follow, or inspirational presence. Our task is to communicate to clients the important needed information, teach the needed skills, correct the faulty habits or thinking, separate present from past, help regulate their emotions, or highlight their strengths.
In the corrective-emotional-experience stance, the problem is attributed to deeply rooted negative emotional experience. The proper therapeutic stance, accordingly, is to provide a corrective emotional experience, a re-parenting. The therapist provides what the client lacked in childhood: mirroring, acceptance, cherishing, engagement, structure, consistency, availability, or socializing expectations. The therapist serves as a nurturing parental presence who respects the client’s boundaries in contrast to the original parent who may have required nurturing and parenting by the client and may have trespassed the client’s boundaries.
Like most other approaches, Collaborative Couple Therapy combines elements of the educational and corrective-emotional-experience stances. The particular nature of this combination emerges out of our therapeutic goal and plan of cure.
The goal of Collaborative Couple Therapy is to better equip partners to solve the moment—to enable them to confide what’s on their minds in a way that leads to talking rather than fighting and withdrawing, fulfills the potential for intimacy available in the moment, and turns them into joint troubleshooters in managing the relationship and dealing with whatever issues arise in it.
The principal method of Collaborative Couple Therapy is doubling—speaking for each partner from an “I” position. The therapist takes the angry, defensive, or avoidant comment a partner just made and replaces it with a connection-seeking, self-disclosing, conciliatory one. In so doing, the therapist models how to have an intimate conversation. Modeling is a classic form of psychoeducation.
Such modeling can also potentially spark a corrective emotional experience. Many couples suffer from spiraling irresolvable angry gridlock or unremitting, spirit-crushing alienation. The therapist’s modeling effort—replacing a partner’s provocative response with a conciliatory one—can trigger a healing emotional exchange between the partners.
In addition to providing corrective emotional experiences between the partners, the collaborative couple therapist tries to do so with the partners. The therapist relates to the partners with the same gentle openness s/he seeks to increase between them—in part to provide them with a model and in part also because relating in this manner is a good way to conduct practically any type of relationship, client-therapist or couple-therapist relationship included.
Unfortunately, we slip at times from gentle openness to judging, from listening to reacting, from empathizing to disapproving. Adopting a stance of gentle openness requires recognizing when we make such slips so we can recover our footing. But we can take it one step further and turn our feeling of disapproval into something useful.
What possible usefulness can a feeling of disapproval serve? It can serve as a countertransference clue. It can put us in touch with that person’s contribution to the relationship problem of the moment, which is the poor job they are doing expressing their point of view—not just to us, but more importantly to their partners. We can double for that person and show them how to do it better. We can take the angry, defensive, avoidant, or otherwise off-putting comment s/he just made and restate it in a way that’s more satisfying to that person and easier for the partner (and ourselves) to hear. Our task, accordingly, is to serve as spokesperson for the partner whom at the moment we find ourselves siding against.
In serving as such a spokesperson, we show how it would look if partners were to confide the thoughts and feelings—especially the wishes, fears, and other vulnerable feelings—they ordinarily keep to themselves and may not fully realize they have. Such an opening up between partners enlivens the moment, raises their spirits, and expands their conception of what’s possible in a relationship. If that’s the case, wouldn’t we want to adopt some professional version of that opening in our relationship with the partners. We can do so by letting the couple in on our thoughts, feelings, strategy, mistakes, and doubts to the extent it is appropriate to do so with clients. We can say things such as:
- “I just realized that I’ve been arguing with you, which means I haven’t been listening very well to what you’ve been trying to tell me. But if I were listening, I’d realize that what you’re trying to tell me is…”
- “I want to interrupt you, Sue, because it looks like Mark is sinking deeper and deeper into the couch and I’m afraid we’re losing him. So let’s find out how he feels about what you’re saying.”
- “This is quite a fight you’re having. Since I’m the therapist, I ought to be doing something about it. So I’ll come over and speak for you and see what I can come up with.”
Adopting a stance of gentle openness also means being receptive to the couple’s input. It means appealing to them as consultants in managing the therapy. It means saying things such as:
- “Is this conversation going well and there is no need for me to intervene, or is it not going so well and I should intervene?”
- “There are twenty minutes left and I want to know whether you’d like to spend them continuing what we’ve just been talking about, getting back to that issue that we left unresolved from last session, or something else entirely?”
- “I’ve just realized that I’ve spent more time today develop Jane’s thinking. Sally, are you feeling left out or ganged up on?”
- “What are you taking away from this session that’s helpful, if anything, and what has been disappointing about it?”
To summarize, in Collaborative Couple Therapy, we combine elements of the educational and corrective-emotional-experience stances and relate to the partners with the same gentle openness we seek to create between them. Such relating requires becoming increasingly skillful in (1) dealing with our inevitable slippage from listening to judging, (2) confiding our thoughts, feelings, strategy, mistakes, and doubts, and (3) appealing to partners as consultants in managing the therapy.
What are the drawbacks to adopting a stance of gentle openness? Is it always such a good idea to be evenhanded and nonjudgmental and to appeal to partners as consultants in managing the therapy? Can we really collaborate with clients in the way I’ve described? What about clients who resist our therapeutic efforts and seek to sabotage the therapy? I plan to discuss these questions in future newsletters.
Hi, Dan. As always, this is so clear, and densely packed with ideas. I think your main method– to “show how it would look if partners were to confide the thoughts and feelings—especially the wishes, fears, and other vulnerable feelings—they ordinarily keep to themselves and may not fully realize they have” is beautiful for a subset of people or moments actually coming from vulnerability.
But as I’ve said before, I worry that this doubling method could whitewash a lot of other commonplace motives and strategies, such as dominating, intimidating, being passive-aggressive, taking advantage, deceiving, stonewalling, obfuscating, etc. After all, we share 99% of our genes with chimpanzees, and we are much smarter than they are at thinking up ways to look out for number one.
When therapists feel judgmental, maybe it is because we are picking up on motives that we may loathe or fear. I think that treating the latter kinds of motives as if they were all about vulnerability, not feeling entitled to feelings, or not being clear about feelings, may make therapists and clients feel more comfortable and “safe,” but there may be several risks: 1) The client-perpetrator may feel still unseen, unknown, still lonely. 2) The client may feel he succeeded in fooling the therapist. 3) The therapist may unknowingly collude with the client in duping the client’s partner. 4) The client’s partner may feel ashamed of seeing the client in a bad light. 5) The client’s partner may see the therapist doesn’t get it and may feel even more discouraged. 5) The client may learn from the therapist a really sophisticated method of manipulation, i.e., how to put on a disarming act of vulnerability and sensitivity.
I’m looking forward to what you come up with for problems like this in future newsletters.
I forgot another “risk” to add to the list above: The client-perpetrator may see that the therapist did recognize his true motives and was so repelled that he made up a nice cover story for the client, resulting in the client feeling rejected, ashamed, or monstrous.
A key link with your body of thought may be “ordinary human feelings.” Anti-social motives are very ordinary, and somehow perhaps compassion can be brought to the person who bears them, but this is challenging because such a person can be dangerous or can accurately be sensed by the therapist as bent on sabotaging the therapy, as you mentioned.
I’m really looking forward to how you, with your typical clarity and compassion, develop your theory further.
Another thought, half-baked at the moment: The therapist needs to respond not just and not mainly to what the client is saying, but also to what she is doing. To the extent the client is being honest, there will be overlap between the saying and doing. If the client is trying to manipulate in any of dozens of ways, then what she is saying may be irrelevant to or contrary to what she is actually doing. The therapist needs to sense these possibilities, and remember that the client’s language of the moment in the session does not necessarily reflect the truth of the couple’s interaction.
What I have just said puts the therapist who yearns to be collaborative in an awkward position. I use the word “yearns” because it fits what I myself feel–based on a deep desire to trust that everyone is coming from goodwill. It is sad to admit this is not the case, not even with our clients, with whom a mutually trusting relationship is supposed to be the foundation and prerequisite for healing. Perhaps we should think of goodwill and trust as the desired outcomes of successful therapy, rather than the prerequisites for it.
If we do not always have honest partners in our clients with whom we can collaborate, does that mean we have to be adversarial? Clients may cast us as adversaries in their own minds and seek to defeat us in various ways. Seeing this, it could be very hard for the therapist not to feel or feel pushed into an adversarial stance. Yuk! Yet, if the therapist can get used to the idea that such shenanigans are part of everyday ordinary human interaction, built into our DNA more or less, then perhaps this wide perspective can reduce the therapist’s shock, distress and tendencies to condemn or whitewash.
Dan, I must confess that the solution I’ve been proposing for you, to view clients’ antisocial, adversarial, sabotaging inclinations as ordinary, commonplace human tendencies, does work for me a little, but only a little, and only in the mildest, least threatening cases. Decades ago I loved client-centered therapy and later your work because such tendencies are unknown or little known in those world views. A safe, friendly world! You show us how to work in a world like that. Can you help make therapy work in a darker world seem less distressing and more likely to be effective than I now feel it to be?
On the other hand, maybe the task is to face the challenges of such work head on and with the courage and fortitude that some therapists naturally, temperamentally possess more than others.
I think it is also true that the extreme gentleness of the therapist in your approach and in client-centered therapy minimizes the likelihood that the client will feel threatened and become adversarial. The likelihood is minimized, but not entirely erased. There is also the possibility that if the therapist becomes attuned to possible deception, manipulation, etc. on the part of the client, the client may perceive the therapist as a threat and may become adversarial in self-defense. Self-fulfilling prophecies.
I really like how you combine the two approaches in the Collaborative model. Also, your term
spirit crushing is so apt. Thank you for another clear description of your approach and the
elements that make it so effective. Joanne
I’ve long understood (though I’ve often forgotten from moment to moment) that therapy is not about changing clients. I can’t change people. Therapy is about understanding people as deeply as I can. Understanding is an ever evolving, ever deepening, and unending experience. When a person feels better understood she feels a little less alone, thus a little less afraid; a little more at ease, thus a little more aware. I believe deepening awareness is profoundly life changing.
This article encourages me to keep refining compassionate understanding of my clients (of all people, for that matter), keep refining my understanding of self, and to transparently reveal those parts of myself that may be useful to clients. Thank you, Dan.
I’m touched by your comment. It gives me a sense of peace. Therapy doesn’t have to be a fight to drag the client someplace “good for them.” Being understood, the client may feel better and see more possibilities. If I see something that might be helpful, I can share it.
But some clients who feel they have something to hide may not welcome being truthfully understood. Then what?
Thank you for your heartfelt response, Judith. At first blush, I think one does more ‘doubling’; repeatedly refining one’s understanding (and so the clients understanding) of the client’s apprehensions through, as Dan writes, “gentle openness.” This attempts to normalize the client’s experience, continues modeling how to confide difficult topics like “my hesitancy to be understood or seen”, and maintains the ‘platform.’
Sometimes I’ll say some variation of the following to a client: “In my imagination I assume you probably have ideas and thoughts that you might prefer to never reveal to anyone. I believe that’s very human and normal. Without revealing any of those private thoughts, would you consider talking about the good intention or what’s helpful in keeping those thoughts private?” If the client doesn’t participate or draws a blank, I’d probably provide a few good intentions for him and then check it out with him (more doubling); rinse, dry, repeat.
When I was younger, I used to work almost exclusively with angry teenagers who were court mandated to see me for therapy after committing any number of crimes. I have many wonderful stories about these kids sincerely confiding in me once I demonstrated my understanding and acceptance of their perspective. One of my many routine questions was, “Help me understand what you hate about coming to see me and how stupid therapy is.” (I actually used saltier language.) Honestly, most of those “delinquent” kids would, at some point, politely state something like, “I don’t mean to criticize you, Doug, but . . .” Pretty remarkable stuff.
So beautiful, helpful, and very funny at the end about the kids! You are referring to a domain of situations I had forgotten about–people trying to protect something precious or fragile. I was thinking more about people who are running hostile power operations directed at their partners or the therapist, who don’t want to get “busted” by the therapist, and who would be radically misunderstood if the therapist were to double for them as if they were coming from vulnerability. (See my earlier comments on this blog.)
If we add your tips to Dan’s tips, that covers so many people and situations that I’d be inclined to say “forget about the power-trippers–you can’t help everybody,” except I’m afraid power operations are too common and ordinary to ignore, and victim partners may need therapeutic rescue.
Furthermore, the people running power operations are usually also Dan’s people and your people, Doug, coming sometimes or often from vulnerability. Victims of power operations may also be perpetrators. Within one person there may be a spectrum of motivations. All this is so complicated that I love the idea that maybe the job is just to try to understand, understand, and understand some more from the client’s point of view, and be tactful about handling what you find out. That’s a hard enough job!
I should give some examples of what I mean by “hostile power operations”: lying, cheating, hiding assets, adopting a menacing tone, throwing a tantrum, giving the “silent treatment,” threatening abandonment, withholding sex or other goodies, crying, making promises with no intention of keeping them; acting sad, hurt or suicidal (to get the other to give in)….Some power operations have the aim of crushing the other’s spirit, making the perpetrator feel superior, like the master, the winner. Examples: behaving in a confusing or unpredictable manner–sometimes nice and sometimes mean; gaslighting, mocking, belittling, adopting a contemptuous tone; withholding acknowledgment, gratitude or affection; passive-aggressive behavior such as perpetually “forgetting,” frustrating, or failing to do what’s needed or expected…..
The perpetrator of such operations may indeed feel vulnerable, especially if his tactics are not very effective. He may feel afraid of exposure, being seen through, being deprived of what he wants; feeling weak, insignificant or worthless.
Fascinating post and comments. Very stimulating. My immediate response to this post is that education and doubling are not the same.
It occurs to me we could think of communication in terms of 3 dimensions: Accurate/Distorted, Expressive/Controlling, and Benevolent/Malevolent. You are aiming for more accurate, expressive, benevolent communication. Hitler specialized in distorted, controlling, malevolent communication. Parents sometimes use accurate, controlling, benevolent communication, as when giving reasonable orders. People who are confused or not in touch with their feelings may use distorted communication, which may also be either controlling or expressive and either malevolent or benevolent. A person can tell the truth in order to hurt someone (accurate, controlling, malevolent) or express hostility without intending particular consequences (accurate, expressive, malevolent).
Writings about I-messages assume they are truthful and well-intentioned (accurate, benevolent). However, I think we sometimes erroneously assume that if we use the prescribed I-message format, the content and intention will automatically fall into place positively. I imagine I-messages can be distorted, either due to confusion or on purpose, and can be used in a very subtle or devious way malevolently. I’d guess I-messages usually have a controlling element, e.g., an effort to prevent the recipient from reacting defensively, which may or may not come from a wish for a better relationship.
An overall point is that there is a difference between form/structure on the one hand, and intention/content on the other. The characteristics of the form do not guarantee the intention.
The intentions underlying an interpersonal “script” that plays out over time may or may not coincide with intentions apparently involved in a moment of interaction. Assessing this may be very difficult. Examples:
Mary and John like and respect each other, basically. In couples therapy, they learn to communicate more and more accurately and from the platform. Their relationship gets better and more loving over time. Their good intentions of the moment coincide with their long-term intentions.
Ellen praises, encourages, validates and admires Henry’s endeavors for an extended period of time so that he comes to depend on her for support for his self-esteem. Suddenly, at a critical moment when he is particularly vulnerable, Ellen lashes out contemptuously with scathing criticism. Because Ellen’s support has become so vital to him, Henry is all the more devastated. Ellen’s “benevolence” in the earlier moments might more accurately be understood as a set-up within a malevolent script.
Peter is honest, sincere, and honorably owns up to his part in any rough patches with Jane. Over time, Jane comes to trust and rely more and more on Peter’s impeccable integrity. She relaxes and lets down her guard. When he suddenly betrays her, she is all the more shattered because her prior trust had become so deep.
I think people rarely become aware of living out malevolent scripts over time, and those who do know what they’re doing are likely loathe to admit it.
Hi Dan,
I just re-read this newsletter. I saw it while I was on vacation and saved it to read again when I was back in “work mode”. As always, your ability to talk clearly about what we do as educators, re-parenters and doublers refocuses and informs my work with couples. Thank you so much.
This week I saw an opportunity to use doubling to help the newish couple I was seeing move into some deeper, yet unexpressed feelings of love and care for one another. They are both quite afraid of intimacy and had very traumatic childhoods. Watching how their body language changed as I doubled each of them, and (of course) checking out whether or not I got it right connected the three of us in a new way. Doubling is such a powerful, yet respectful tool.