Accepting Derailing

Most of the time most of us therapists work as hard as we can to keep a treatment going, knowing that attempts to derail therapy have many meanings that can be explored and understood.  I know that I have always been extremely reluctant to “give up.”

However, in this post we will be looking at the few circumstances that we may encounter during our careers in which accepting derailing attempts is the only course of action the couple therapist can take.  The clearest and most obvious of these is the situation in which one or both partners cannot contain or curtail seriously threatening violence toward the other partner or the therapist.  The safety required to conduct an effective couple treatment cannot be established in this atmosphere.

Other derailing attempts are more subtle or indirect.  The partner who persistently over many months of treatment insists that they are always the victim of the other partner’s bad behavior, continually blaming the other for all the couple’s problems, will probably successfully derail a treatment.  The partner who persistently over many months of treatment refuses to consider any connection between present issues and childhood history may be saying that the unearthing and exploration of the traumas of their past are unbearable.  Neurodynamic Couples Therapy joins with neuropsychologists in purporting that the nonconscious part of our right brains serves a protective function by not allowing us to be conscious of material that is perceived to be too dangerous to mental and/or emotional integrity.

Every type of successful derailing of a treatment is fueled by terror, even those coming from a partner who is threatening violence.  We all know about this–the person who is the most threatening is the one who, underneath, is the most afraid.  The fear of literally coming mentally unraveled if terrifying memories are exposed is a natural mechanism for protecting our brains.  I have learned to respect this terror.  Our right brains are always in charge of the pacing of our abilities to self-explore, and they are absolutely correct about what we can and cannot tolerate.  Accepting the treatment derailing of a terrified person is the safest and most empathic route to take.

When one partner clearly states that they do not want to be in the relationship or that they do not want to be in treatment. these statements of preference must be respected.  While we might put some effort into exploring these declarations, it is not our job to “talk them into” staying in their relationship or treatment.  Transitioning into divorce counseling or continuing to see one partner in individual therapy might be discussed as options.  The pros and cons of these decisions should be carefully explored, since either involves considerable changes to the frame of the treatment.  For example, the safety to the nonconscious that is necessary for successful neurodynamic couple treatment usually cannot be reestablished once the therapist has transitioned to seeing one of the partners in individual treatment.

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