Couple Therapy with Severely Conflicted Partners

The goal of life is to become mature adults who have achieved a sense of differentiation of self (Bowen, 1976: 1978): that is, who have learned how to balance the two life forces of individuation and togetherness (McGoldrick, & Carter, 2001: Titelman, 1998: Rovers, 2000). Differentiation of self in couple relationships can also be defined as a secure attachment pattern (Bowlby, 1969, 1973, 1980, 1988). The opposite of differentiation of self is emotional reactivity that can be expressed in family of origin “wounds” like fusion or emotional cutoff as well as insecure attachment patterns like preoccupied and avoidant. This journey to a mature balancing of individuation and togetherness begins within one’s family of origin and is best expressed yet most complicated in a couple relationship. Each partner brings both gifts and  wounds into their couple relationship. When these wounds are severe, couples often enter therapy for help. How does a therapist handle a couple that is highly emotionally reactive which is expressed in conflictual cycles of fusion and cutoff? What concepts and techniques can be taken from Bowen and attachment theory to guide the marital therapist?

Bowen Theory

Bowen Theory views the family as one type of natural system characterized as an emotional unit consisting of interlocking relationships best understood within a multigenerational and historical context. These relationships are governed by the need to counterbalance the life forces of individuation and togetherness which operate in all natural systems (Kerr & Bowen, 1988). Bowen theory provides a conceptual structure for recognizing the impact of relationships between partners and family members, and within society as a whole, especially factors that influence the health and direction of family relationships.

Differentiation of Self

The cornerstone of Bowen Theory is differentiation of self. In the interpersonal realm, differentiation of self can be understood as the degree to which a person develops into a distinct and thinking individual while interacting and connecting with significant others. More differentiated individuals are thought to be able to establish greater autonomy in a significant relationship and to achieve emotional togetherness or intimacy at the same time. In other words, greater differentiation of self permits one to maintain secure connections with those who hold different opinions and to resist the use of emotional cutoff or fusion to maintain one’s sense of self (Skowron, 2000). Differentiation of self is a the lifelong process of balancing the forces of togtherness/intimacy and individuation rather than a state of being or a goal that can ever be achieved.

Enmeshment and fusion are our family of origin wounds;  the areas where partners can struggle in significant relationships. Wounds are born within the family of origin so as to be old habits that are fully functional within couple relationships.  These wounds are not our fault, but they are now our responsibility to repair.  Partners may pretend not to see them or take a long time to deal with them. Differentiation is characterized in the couple relationship as the patterns in which each partner exhibits emotional individuality and the means used to balance the need for intimacy and individualion concurrently.

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Differentiation

         Intimacy           (balancing)              Individuation

Enmeshment / Fusion                                                                                                                                                                                Emotional Cutoff

0 …………25……………50……………75…………….100…………….75……………50……………25…………….0

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Bowen (Kerr & Bowen, 1988) divided his scale of differentiation into four ranges of functioning. Bowen suggested that most people probably function within the 50- 75 range on either side of this scale of differentiation. These people can make choices and are secure enough to move back and forth between relationships and goal-directed activity. They are able to balance individuation and togetherness. People in the 0-50 range are described as people who have difficulty to differentiate between thoughts and feelings and tend to be either fused or cutoff. Bowen suggested that few people function in the 75-100 range and he left the 95-100 range as an ideal.

Attachment Theory

Attachment and Couple Relationships

Bowlby’s attachment theory provides the theoretical model to account for adult love relationships which concentrates on such issues as emotional bonds, as well as adaptive needs for protection, security and connectedness with significant others (Hazan & Shaver, 1987; Johnson, 1996; Dankoski, 2001). Recent literature has begun to examine the relationship between attachment patterns learned in childhood and adult attachment patterns in couple relationships. Important differences exist between parent-child and couple attachments, such as the more reciprocal nature of the couple and the role of sexuality. The work of adult attachment by Hazan and Shaver (1987) has drawn parallels with the work of Bowlby.

Hazan and Shaver (1987) used attachment patterns as descriptors for adults. They contend that romantic love can be viewed as an attachment process and that the three major attachment styles of childhood are manifest in romantic love.  Adults who identified themselves as secure could get closer to others and be more comfortable being dependent upon others. They had little worry about abandonment. Adults who saw themselves as avoidant acknowledged their discomfort with closeness and difficulty in trusting others. These adults got nervous when love came too close. Adults with an preoccupied  pattern worried that their partner did not really love them and thus wanted to get very close and hold onto their partners.

Family of Origin Theory and Attachment Theory: A Synthesis

To illustrate attachment patterns,  Bowlby borrowed a schema from the biologist Waddington’s theory of epigentic developmental pathways (Simpson & Rholes, 1998). This schema of attachment patterns pictures a wide range of normal development in the center of the pathways, and more dysfunctional development on both extremes.

In Bowlby’s theory of development, there is no single route to normality or secure-enough attachment pattern. Development is not blocked by particular experiences of deficits but rather re-routed or constrained into increasingly particular pathways over the wide range of normal to abnormal development (Caperton-Brown, 1992). A full classification schema, suggested by Goldberg’s (1991) research, found that attachment classifications can range from secure to marginally secure to insecure.  Even the ‘normal’ or secure range is made up of numerous pathways, or branches, or clusters. The road to security is not a primrose path, but a process which involves risks, choices and anxieties. This schema conceives a continuous measure, moving away from set categorical traits of attachment patterns. In addition, this schema leaves space for changes and healing as one experiences new attachment figures in adolescence and adulthood.  Falling in love or the birth of a child can necessitate conscious re-evaluations of relationship patterns. Therapy, such as a reexamination of one’s family of origin attachment patterns or emotionally focused couple therapy,  can also fashion changes in present attachment patterns.

Family of origin theory demonstrated a continuum of relationship styles from enmeshed or cut odd to differentiated. Attachment theory offered three attachment patterns for adults ranging from preoccupied or avoidant to secure. A full range of possible attachment patterns, based upon both family of origin theory and attachment theory, can be illustrated by means of Bowlby’s multi-pathway schema. In this way, the normal secure / differentiated development in the center of the pathways presents the healthy range of possibilities of different blends of intimacy and individuation that can operate in one’s life. In a similar vein as Knudson-Martin (1994, 2002), this schema enables people to live and relate while leaning more on one side of the pathways, be that with preference for intimacy or for individuation, according to their own life experiences, and still reach the goal of secure/differentiation. This schema more clearly accents these various pathways to secure/differentiated and both forces of intimacy and individuation are given equal, reciprocal importance.  On the one hand, there is a want for autonomy, freedom and individuation AND, on the other hand, there is a need for intimacy, closeness, and togetherness.

If one’s attachment patterns are located towards the outsides of the schema of attachment patterns, one begins to experience more dysfunctional expressions of attachment such as preoccupied and enmeshed on the one side, and avoidant and cutoff on the other side.  Enmeshment and cut-off would be seen as most dysfunctional as described by Bowen (1978).  Enmeshed and cut-off people live in a feeling world and are unable to differentiate between thoughts and feelings. Enmeshed people are suggestible and quick to imitate others to gain acceptance or to seek out the ideal close relationship, while, at the other end of the continuum, cut-off people may be fearful or dismissive of relationship, sometimes seen as lone rangers. Enmeshed and cut-off people are both in the realm of insecure/undifferentiated and thus can be sort of back doors to each other. Many highly enmeshed or cut-off people can shift from an enmeshed attachment pattern to cut-off quickly or reactively, a sort of need-you-desperately or dump-you-quickly knee jerk reaction (Bowen, 1978). Secure/differentiated people tend to be more uniform and regular in their attachment patterns, treating people in a similar and consistent manner.

It is strongly noted, however, that all these attachment patterns lie on a descriptive continuum and that exact diagnosis is not always possible or desirable. The Bowen scale of differentiation allows graphic, abeit more theoretical, assessments to be made that may help clients find a possible place to position and know themselves on the range of attachment patterns. Within this range of possible attachment patterns, and since no one scores a perfect secure/differentiated 100,  there can be a variety of relationship expressions that probably tips each individual’s attachment pattern either towards secure or insecure, towards greater emphasis on intimacy or individuation.  This schema helps choreograph the couple’s dance of attachment/differentiation more distinctly. By depicting potential placement on the schema of attachment patterns for clients, the picture can well be worth a thousand words both for their past and present attachment patterns and for direction in their therapy.

There are many possible attachment patterns on this schema but four attachment clusters are noted: the more functional middle clusters of secure/preoccupied and secure/avoidant and the more dysfunctional outer cludters of enmeshed/preoccupied and cut-off/avoidant.

Although perhaps at first perplexing to the client,  the different clusters illustrated enable clients and therapist to talk about movement towards a more secure/diffferentiated centre, possible areas of insecurity in relationships, and to mutually arrive at some attachment descriptors for both partners.

Pathways taken in life are dependent upon many past experiences, but especially family of origin legacy. Some childhood experiences may have caused a person to incline or move further into the direction of enmeshed/preoccupied. Other experiences within the family of origin may have had the effect of swaying a person into the direction of  avoidant/cutoff. A detailed family of origin history, using instruments like the genogram, would expose childhood attachment patterns and enable both patners and therapist to become more aware of antecedents of present relationship problems, thus gaining a more complete picture of present attachment patterns. By means of this schema of attachment patterns, the partners would have more self-knowledge and a better foundation upon which to engage in their relationship.

Therapy is also delineated on this schema. The person whose attachment pattern leans on the enmeshed/preoccupied side would be seen as being fearful of further individuation and therefore, more individuating steps would be the direction of therapy. On the other hand, the person who prefers the cutoff/avoidant side of this attachment schema would be seen as being fearful of intimacy and steps towards a deeper connectedness would be called for in therapy. Implications for therapy are elaborated later in this paper.

Couple as an Emotional System

The family is seen as a multigenerational emotional unit or a system in which each partner is characterized by his or her level of differentiation and functioning position as well as by the multigenerational transmission process. Multigenerational transmission process presupposes a notion that family dysfunction results from the transmission of undifferentiation over several generations. As parents project onto their children, three things can happen. Some children emerge more involved in the parental triangle and with a lower level of differentiation, other children might be more minimally involved and emerge with a similar level of differentiation, and some children might be more free of the family emotional system and emerge with a higher level of differentiation (Kerr, 2003). Functioning position assumes that certain functions are generated in every family emotional system and that each individual’s personality is shaped according to his or her functioning position in the family (Kerr & Bowen, 1988). Values, beliefs, feelings, attitudes and behaviors are influenced by one’s functioning position which operates in a reciprocal relationship. The multigenerational transmission process assumes that each family member is both unique as well as shares similar characteristics with all other family members.

The nuclear family emotional system assumes that people choose partners who are equally differentiated.  Therefore, the undifferentiated person will choose a partner who is “equally fused to his or her family of origin” (Goldenberg & Goldenberg, 1991). The undifferentiated and fused married couple will likely produce a family with similar characteristics resulting in an unstable nuclear family emotional system which seeks means and ways of maintaining stability and reducing tension.  High levels of fusion within the couple relationship increase the likelihood of high levels of anxiety and instability as well as the partner’s propensity to seek resolution through conflict, distancing, impaired functioning of one partner, the couple becoming overly concerned about a child, or symptomatic patterns such as chronic and overt marital conflict, emotional distance, physical or emotional dysfunction in one spouse or psychological impairment of one or more children (Goldenberg & Goldenberg, 1991).

Triangles

The triangle is the “basic building block” (Bowen, 1978) of the family’s emotional system. In times of stability and calm, a two person system can remain relatively stress free. A triangle is formed when anxiety or emotional tension threatens the couple relationship and one or both partners involve a third person, activity or addiction. When tension within the triangle becomes too high, it spreads to form series of interlocking triangles that can include another person like parent or child, or other distractions like alcohol or work (Goldenberg & Goldenberg, 1991). A triangle assumes a “rigid or fixed dysfunctional stability” characterized by a lack of differentiation and openness among members (Titleman, 1998, p.12). Distancing or the fusion between two members occurs and, as a result, the relationship becomes unstable. Consequently, others become involved or triangled and interlocking triangles are formed.

Functions of the Therapist

For Bowen, the role of the therapist is likened to that of a coach, and in working with both partners, the coach has the following functions: a) engaging the couple: bringing down emotional reactivity; b) system mapping: defining and clarifying the relationship between the spouses, especially helping partners become thoughtful about their own wounds or emotional triggers; c) keeping oneself de-triangled from the family emotional system; d) demonstrating differentiation of self by the use of “I statements” and constructive talking and listening during therapy as a means of mentoring for the partners. In Bowen theory, teaching about family systems, helping partners become more thoughtful about their place in the system and their own contribution to the problem and helping couples plan new modes of interaction is given precedence over interpretation, insight or emotional engagement.

The learned patterns of attachment and emotional expressiveness typically learned within the family of origin will impact on every other relationship both within and outside the family system, especially with one’s chosen partner. Therefore, it would make sense that when troubles come to a couple relationship, there are two places to look for a better understanding of the causes of these troubles as well as for the solution. These two places are: a) within oneself, especially within the couple relationship in the here and now: and b) within one’s relationship in the family of origin where these troubles probably started as childhood wounds. Not all people are able to be in touch with or articulate the here and now experiences and feelings that are present in couple relationships.  Some people don’t know what they are feeling or why they act as they do. Telling stories of what happened within their family of origin can be easier, safer, somewhat more removed. It provides a safer base and an experience upon which they can begin to comprehend their present relationship as well as their feelings. It offers partners a “why” to how the wounds are dancing in their present couple relationship. Family of origin therapy, however, is not to relive an old memory or to blame parents for all that may have gone wrong in life. Rather, a review of  family of origin relationship patterns, from the “there and then” can provide a “working model” or blueprint of  present functioning and thus help partners obtain a better grasp of the “here and now”. Unfinished business of the past is probably one of the main issues partners trip over again and again in their present relationship. The old family of origin map and attachment patterns that  have been followed most of one’s life needs adjustment and updating to better fit present adult life relationships. Knowing where one came from, in terms of family of origin and attachment patterns, enables one to seek paths and pathways towards the middle ground of more secure/differentiated relationship with one’s partner. In other words, we can stand more solidly on the two feet of past and present attachment patterns by observing our family of origin functioning and by focussing on present emotional attachments with partners. Our family of origin is probably one of the most powerful, influential, and formative influences on our life. So much happened with the family of origin within the first 6-10 years of our lives that one might say we are who our family of origin created us to be. Each one of us has a natural curiosity to know our past, our family of origin. Most of us go through phases of hating or being disconnected from our parents, only to realize somewhere in the years of our lives that I am really a little bit like of each my parents, and this too is a step on the road to self integration.

As well, when partners can stand on the two feet of knowing themselves, their family of origin past attachment patterns and wounds and their here and now emotional connectedness with their partner, both partners also have two places to go to heal these wounds and re-create a new dance of intimacy and individuation. Partners are strongly encouraged to do couple therapy together so that they can address the issues that dance between them; for example, emotional security and trust, communication, knowing themselves better, and spirituality. Partners are also healing their couple wounds when they re-create an improved relationship with their respective parents and begin to practice new attachment patterns with their parents. In other words, as Bowlby stated, partners have to adjust their working models and since these working models were created in a person’s relationship with their parents, it would only make sense to address the issues at their source. Doing a extended family map so that one can know oneself better, and talking over and communicating one’s wounds as well as one’s newly chosen attachment desires with parents can only help to unpack and sort through the many steps each person needs to take responsibility for their own dance of wounds. In other words, to change one’s attachment patterns with  parents is to change  attachment patterns with all others, especially partners. This can be all the more essential if one partner is not yet open or willing to make changes in self or the relationship. Bowen suggests that couple therapy can be done with only one partner present, for when one partner changes, others around them will also have to change because a more differentiated partner will no longer be engaging in that old dance of wounds they had learned in childhood and used in their couple relationship. In other words, the goal of therapy is to get one or both partners to become thoughtful and change their own contribution to the couple relationship pattern, interrupting the couple interaction flow, and helping partners become more differentiated and mature.

Engaging the Couple: Bringing down emotional reactivity

Example: The Case of Mary and Joe

Joe and Mary presented in therapy with severe couple dysfunction and conflict. They have two teenage daughters who are in strong rebellion, often refusing to go to school and who were in constant conflict with mom and dad and each other. Mary is the oldest child and presents in an enmeshed/preoccupied attachment style while Joe is the youngest in his family and tells stories of his childhood days as a loner, in his room with his computer. Social agencies have become involved with the oldest daughter.

When Joe and Mary came to my office for the first session, they sat at opposite ends of the couch. As they shared the story of why they were here in therapy, they would exchange stares at each other to the point that they would interrupt their story to comment on their partner’s facial or bodily gestures. Near the end of the first session of therapy ….

Coach: So I hear that you are both hurting and that you have expectations of your partner that are not being met. I was wondering what you think your own contribution to the couple problem might be?

Mary: I want Joe to change, get his head out of the sand and start take responsibility for the girls. He never …. (she looks over at Joe) …. what are you saying by that face? See! There you go again, thinking that it is not your fault.

Coach: (interrupting). Mary. I want you to look at me and tell me again what you see your contribution to be in this couple difficulty….. not what you see Joe’s problem to be. Mary can you slow down a bit, look at me and tell me. I am listening.

Coach: (interrupting) Mary, I want to know more about what you might see your faults to be. I am of the opinion that when each of us become aware of and acknowledges our own contribution to the problem, then things can begin to change. I would like to move you and Joe from “you – statements to “I – statements”. So please continue and tell me about yourself.

Mary: I can get so angry at times. I know that I lose it with Joe and with the girls. I just want them to become more responsible for themselves.

Coach: What things would you want them to begin doing or stop doing?

Mary: Well. I need Joe to finish his job of writing out our contract with the girls.

Coach: (turning to Joe) Joe. What do you hear Mary saying?

Joe: She is trying to tell me that I never do anything around the house and that I don’t care. She gets me so angry!

Coach: Joe. Slow down. That is not what I heard Mary say. (turning to Mary) What I heard you say, Mary, was that you want Joe to finish the job he promised to do, to write down the contract you both had negotiated with the girls. Is that right Mary?

Mary: Yes

Coach: Joe, can you hear just that request for the contract?

Joe: Yes, but …(looks at Mary) …. see, she thinks that I never do anything!

Coach: Joe. Look at me. Let’s just stick to the issue of the contract. Tell me again what you heard Mary say?

Joe: Well, she is right. I have not written it out, but …

Coach: (interrupting) Good Joe. So I hear you saying that you have a job to do and to write out the contract with the girls. Is that correct?

Joe: Yes. I can do that.

Systems Mapping: Defining and clarifying the relationship between the spouses

The schema of attachment patterns is a good place to begin to have partners look at knowing themselves and understanding their role in the couple difficulties. Partners can be shown the schema and, after it is explained to them, asked where they see themselves and their partner on it. Often partners are on the opposite ends of the continum with one partner more preoccupied while the other partner more avoidant. The dance of wounds between the partners can be one of pursue/flee with neither partners’s needs really being met. On the family system level, it would probably also be true that one partner is more enmeshed with their family of origin while the other is very distant from theirs, and family of origin interference often can complicate the couple difficulties.

Early in therapy, the coach begins to map out the couple relationships as well as their bigger family systems. The genogram or family map is an excellent way to do this. Gilles-Donovan (1991) writes that “the focus is on knowing the system, the structure and how it works” (p.9). The genogram is a dynamic, evolving understanding of the family system and the coach can highlight patterns and share these with the couple that enable them to begin making connections between their family system and their present attachment patterns and conflictual problems. Bowen encourages clients to become researchers and observers of their own family dynamic and begin to see their role or function within it, as well as the dance of wounds that is happening between the partners.Having partners tell their family of origin stories can be a time of insight into self as well as their partner.

Example:

The genogram for Joe and Mary follows. One of the highlights of therapy was when Joe began to observe and comment on the frequency of his distant relationships with most significant others in his life. Prior to that time, Joe was quite adamant that Mary was the real one at fault with her volatile ways of interacting, and if she were to simple change her voice and volume, all would be better. Now, Joe began to see that he is distant with most people, even his mother and brother who are quiet people like himself. Joe started to describe himself as inclining to “be in his head” and acknowledged his need to invest himself and connect more in relationships.

Couple therapy needs to focus on patterns rather than on content so that partners may learn about their own couple system and the wider family system each comes from. This sets the stage for further differentiation of self

De-Triangling: Learning to stay out of the family emotional system

Example:

After three sessions of couple therapy, having obtained their stories of the couple’s difficulties and began work on constructing their genograms, there were two individual sessions with both partners separately. This is session four, with Mary alone.

Mary: We are thinking of having our oldest daughter stay with Joe’s brother and his wife for awhile. They have agreed to take her, and it might help in the house. But I was talking with Alice (Joe’s brother’s wife) yesterday and she began to rub it in my face how I can’t do anything right. I let her know exactly what I thought of her. She makes me so mad!

Coach: Mary. I have the impression that you act on the motto: Fire! Ready! Aim! And that you do have a lot of fire-power.

Mary: (laughing) That is what my brother and sister use to call me when I was young: fire-power.

Coach: Fire is a great thing: it gives off heat and light and is necessary for life. I wonder where all that fire-power comes from?

Mary: I had to fight for everything I have. My dad was abusive and, as the oldest, I had to fight for myself and my brother and sister.

Coach: Are you aware when your fire-power gets too hot?

Mary: (laughing) Often too late. I know that I have to work on that.

Coach: How do you think you might want to do that?

Demonstrating differentiation of self by the use of “I statements”

As partners become more aware of and thoughtful about their place within the couple system as well as their larger family systems, change can begin. By observing and listening to each other, partners can begin to see and think about themselves in systemic terms and grasp their own starring role in the couple conflict.  Partners will need to make changes to their old dysfunctional attachment patterns and begin the joint couple reconstruction project of non-reactive communication and reentry into relationship. McGoldrick & Carter (2001) write that:

the basic idea of coaching is that, if you can change the part you play in your family, and hold it despite the family’s reaction while keeping in emotional contact with family members, you maximize the likelihood that they will eventually change to accommodate your change (p. 291).

Thus begins the main work of therapy which is making shifts in one’s position especially through taking responsibility for self and the use of “I-statements”.  An “I-statement” is a complete and engaging statement of one’s thoughts , feelings and wants on a subject that is spoken nicely and honestly. The Dialogue Wheel (Rovers, 2005) is one model for expressing I-statements.

The Dialogue wheel is a communication tool that can be used to see the wounds and attachment patterns within couple relationships and begin the process of talking about them.

Example:

Mary: Joe, I notice that when we begin to talk to the girls about something, you often have the habit of saying nothing at all and leave it all up to me. I assume that you are afraid of these confrontations with the girls. This makes me feel uncomfortable, alone and, in the end, frustrated and angry. I am afraid that it too often ends up a fight between me and the girls and that you come in to take their side. I want us to have a contract with the girls so that everyone knows what to expect and what the rules are and then I want us to stand together when we need to enforce them. I appreciate that I am asking a lot of you and that you prefer to be left alone and out of these discussions. I hope we can work to reach agreement between you and I with the girls.

Coach: Thanks Mary. Joe, what are you hearing?

Joe: I know that I need to get involved more when we deal with the girls, but I have always been afraid of confrontation ever since I was a kid. I run from it.

Coach: Tell me more about that, Joe?

Conclusion

Differentiation is about learning to become more individuated while remaining connected in one significant relationships; it is about discovering that balance between intimacy and individuation and taking responsibility for self with one’s partner and other significant people. Some of these conceptual tools and techniques from Bowen Theory have a strong teaching component: schema of attachment patterns, attachment clusters, the genogram, and the Dialogue Wheel. When integrated in therapy, it can have a powerful effect of learning to find a new way to relate with one’s partner and family of origin.

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