DESCRIPTION:

The couple in this session comes to Esther for guidance on how to create a space of safety for physical intimacy. They are gay men who have been together for 14 years and were married only two weeks before the session.

• One of the partners has a history of PTSD with addictions and substance abuse.
• There were several infidelities on the part of that same partner one year before they came for this session.
• They want to stay together in spite of the infidelities.
• They have fairly consistent, defined roles—one is the talker; the other is the quiet caretaker.
• When they begin the session the quiet caretaker would like to understand more about his partner’s trauma so he can be sure not to trigger him and also be able to help him more. The talker wants to be better able to receive what is offered without being triggered.

OUTLINE:

What to listen for in this session

• Note the pacing. It’s very different from the other two sessions. It’s slow, rhythmic, subdued. Esther explains that this is her practice with trauma as she does not want to trigger or flood. She feels her way into an understanding of how much and at what pace to move forward.
• Look for Perel to follow up partners’ statements and get the intimate meanings behind them by asking for “more.”
• Notice how these partners, who’ve been together for 14 years, have never talked in depth about one partner’s trauma—a central emotional event—and how the partner who is talkative has asked almost no questions about his partner in that same time.

After introducing themselves, they tell the story of the benign birthday “surprise” tour which had to be abandoned when it triggered the partner with a trauma history, but it is clear they have talked little about the history behind the response. Perel says later she is curious about how the norms for how much or little to share were set. At the end of the segment, they talk about another trauma manifestation they’d both like to change— that the partner with a trauma history often flinches when his partner touches him. When the touch-focused partner reiterates that he wants to learn more about how his partner thinks so he can avoid triggering him, Perel replies Maybe he should learn from you.

In the analysis, Perel and Simon discuss trauma in relationships and whether this couple’s situation is unique. Perel explains that it is not and goes on to say how common it is to have only the manifestations of trauma in a relationship without any trauma history disclosed or even known.

Based on what she hears in this segment, including the constant use of the word “safe,” Perel is clear that this session needs a strong, solid, tender container and it is her responsibility to provide it. She comments that she asks fewer questions than usual because of the trauma except for when she wants to know more:

When I hear things like ‘He knows a little.’ I ask ‘What is a little?’ because it’s important to hear the intimate meanings behind the words.

In the analysis, Perel and Simon discuss how there is agreement in the field about the need to avoid re-traumatization but there is also vigorous debate about how much revelation is too much and what is not enough. She comments that people often present their approaches about this as if they have the definitive answer. Her approach is different:

            With trauma like this, I think you feel it out, rather than come in with your    certainty.

She also goes into detail on the pacing and approach she uses in this session. Because of the trauma history, she maintains a rhythmic and slow pace. She talks less, asks fewer questions, and is less directive than she might otherwise be. She pays special attention to checking the boundaries—between the partners and between them and herself.

She already has a clear sense of real imbalance in the relationship, so the questions she does ask are about the couple’s complementarity and power dynamic.

• How did they create their interrelatedness of roles?
• How do they communicate closeness and distance?
• How do they deal with vulnerability?
• How do they express caring and needs?   

In the third segment she begins to normalize some of the feelings and reactions related to the partner’s past trauma. He asks and she respond that these reactions are normal for someone with his history. This is where some modeling begins. Perel does some work to help the traumatized partner integrate his words with affect and his body. She then works individually with the other partner who for the first time in this session, acknowledges that he has his own vulnerabilities.

This is the pattern for the rest of the session—individual work with one partner alternating with the other. She points out that while working with one partner, she is also modeling for the other.  

In the analysis, Perel uses the Vulnerability Cycle to explain the partners’ profound though not uncommon dysfunction:

• Tender touch triggers one partner’s survival strategy–to freeze.
• When he freezes, the other partner’s survival strategy of withdrawl kicks in.
• So they both end up feeling isolated.

Perel is very concrete with the couple about how to change this dynamic. She encourages the partner who freezes, to take his time, “reset his dial” to accept the tender touch. To the partner who withdraws, she advises:

            Stay steady while he resets his dial. When you stay steady, then you will both       have what you want.

From this point on, Perel is clear that her work is to help them recalibrate their relationship for more balance and a start on the road to greater intimacy.

The fourth segment begins with both partners saying that they’ve been much more honest and open since the discovery of the infidelities. Perel turns her attention to work with the caretaking partner. She asks him what is was like to step up and ask for something—which he did in the wake of his partner’s infidelity. And she continues to follow the thread—Where did you learn to refrain from asking, wanting, needing. And he begins to tell his story which is also about his own trauma.

Perel continues to work with him modeling for his husband how to ask questions and learn about his partner. Then she passes the baton to the partner by saying Ask him. From that point on, Perel coaches him.

Her goal is for each partner, she explains, is to have an experience that is the opposite of their usual. The one who is always taking center stage will have to reach out, recognize, give and ask about his partner’s needs. The caretaker will learn to ask for what he wants—not just for crumbs and not only in a crisis—and he must then receive.

The fifth segment increases in intensity as the quiet partner talks about coming out. Perel, in a classic “more” moment, follows his story.  When he says he never came out to his father who has since died, Perel has him tell his father now. He said his father answered I know. What’s the big deal? Perel asks for more—What’s it like for you? He said that one part is OK with it. And the other part? asks Perel. He answers: Why don’t you want to get to know me better? and he cries.

Then she turns to his partner who is leaning in and asks if he’d like to come closer and then Do you want to do what you said? (hug him) and he does. Perel picks up the pace turning from one to another coaching each in this new behavior of the partner comforting his care-taking partner. 

In the analysis, she talks about the moment when he said: Why don’t you want to get to know me better. This is the line that takes him into the vortex of pain, says Perel and in the unedited session she had him repeat it many times so he can fully go into that place and then experience the release of tears.

She also walks through every step of the breakthroughs in this segment She explains how she’s using the 7 Basic Verbs of Relationships— to ask, to give, to take, to receive, to imagine or play to share and to refuse—and she describes how therapists can use these words in their own work. This is how Perel summarizes the progress to this point:

            What this couple asked for when they came in was more of the same—the            same behaviors that had kept their relationship unbalanced for 14 years. But       now the one who was the giver is learning to ask and receive and the one who         took center stage is giving and listening with empathy.

The final section stays with this change and reinforces the shift. Perel works again with the partner who’s suffered sexual abuse encouraging him to say I feel instead of It feels. She explores how he feels when his partner holds his hand and eventually suggests his partner hold his face, locking eyes, and in that experience there is a breakthrough. While his partner assures him he is safe, the tears come.

Perel then begins teaching the partners how to reinforce these new behaviors going forward. In the analysis, she says that the key to effectively reinforcing a new behavior is to say something short and positive in the moment. Quick and direct is best: I like you doing this, That’s nice, Let’s do this again, Thank you, This is right.

She describes the 3-step process of learning new behaviors— imitating, identifying and then internalizing. This practice helps with the internalizing.

In the analysis, Esther and Rich do a deep dive into the topic of couples and sexual trauma. Perel talks about seeing that part of the difficulty for the partner who’d experienced sexual trauma was that whatever “feels good” has been contaminated by the sexual abuse.  She does not move any further into that area, but keeps her focus narrow and goes instead for a new embodied experience. She works on a piece of recovery for the partner who’s been traumatized and by doing that in the presence of the other partner she also works on the erotic re-connection of both.

The goal of working on sexual trauma, says Perel, is not only to deal with pain but also to validating sexual pleasure. That is the erotic recovery. If you cannot experience sexual pleasure, then the integration of safety and eroticism in not yet complete.

OBJECTIVES:

Articulate 5 of the 7 Basic Verbs of Relationship and explain how to use them to help clients talk about sexuality and relationships.

Articulate two strategies partners can use to reinforce each other’s positive behavior changes and I can explain why they’re effective.