Interrupting Derailing

Most therapists have had the experience of feeling that a treatment is being derailed and perhaps headed for failure.  Even when we are able to see it coming and try to redirect the treatment, it can be like attempting to turn a battleship around (as the saying goes).

Instead, it is best to know the techniques for interrupting derailing of the treatment from the beginning.  The primary one is maintaining focus on the couple system.  The neurodynamic couple therapist must understand what is being relived during couples’ repetitive conflicts, rather than focusing on one or both partners’ individual issues.  For example, problems like alcoholism, mood disorders, compulsive lying, abusive behavior, affairs, etc., should be viewed in terms of their role in the couple’s system.  Conceptualizing these types of presenting difficulties as the primary cause of a couple’s struggles will derail the couple treatment.  Instead, every behavior that appears problematic, or perhaps even pathological, must be conceptualized as necessary to co-create scenarios in which unmetabolized emotions can be relived, spoken and integrated.

I have treated couples in which issues like alcoholism or a psychiatric diagnosis did not hijack the couple treatment.  In these cases, the partner with these challenges took responsibility for their own treatment, and their individual issues did not get used by the couple system to create conflict.  In like manner, people who do not need these types of problems in order to relive childhood unfinished business will not be attracted to a potential partner who has not taken responsibility for managing themselves in one of these areas.

Attempts to derail treatment that are initiated by one or both partners can show up in several ways.  Being persistently argumentative with the therapist during treatment; refusing to take responsibility for any part of the couple’s problems; continually breaking the rules, such as not paying in a timely manner or not showing up for treatment in hopes that the therapist will continue with only one partner; or being regularly verbally abusive during sessions are all examples of potentially derailing behavior.  Any of these should be confronted with compassion and curiosity to maintain the safety of the treatment and determine the role of the behavior in bringing old emotions to the surface.

The verbiage I have used to interrupt these types of derailing specifies the derailing behavior and then expresses an interest in understanding why the couple system needs this behavior in order to relive something from their pasts.  I might say something like, “It seems to me that you might be doing things to make this therapy not work.  I know that there is a very good reason that you’re doing this, and I want to understand what that is.”  A particularly tricky type of derailing is seen in the types of clients who seem committed to being threatening.  I have said to such a person, “You are frightening me, and I can’t be helpful if I’m scared.  What should we do about this?”

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