AEDP For Couples
ESSENTIAL ARTICLES IN CAMFT'S MAGAZINE
Article 1: What is Accelerated Experiential Dynamic Psychotherapy for Couples (AEDPfC)?
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from CAMFT magazine by David Mars Ph.D., LMFT, developer of AEDPfC
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CAMFT Article 2 - 2018
AEDPfC - Building Whole
AEDP FOR COUPLES:
From Stuckness and Reactivity to the Felt Experience of Love
By David Mars, MFT, PhD
This paper offers a highly condensed description of the theory and practice of Accelerated Experiential Dynamic Psychotherapy (AEDP) for Couples.
It describes and demonstrates a somatically focused orientation of tracking the intersubjective field phenomena of both members of the couple. The paper further describes how AEDP for Couples brings explicit awareness to the felt experience of love between the couple members beginning in the first session in order to set a safe container for the transformative work to follow. It describes and shows examples of working with “edges”, the paradoxical and initially non-conscious embodied reactions that are both “for” and against the very changes the couple members want and need to make in treatment.
The paper shows the theory and practice of catalyzing in couples: a.) being more attuned, more self-reflective, loving and responsive to the needs of the other partner within sessions and at home, b.) cultivating new capacities of perceiving and receiving the other partner’s differing ways of experiencing and expressing not only “affect” per se, but also in a whole range of other “channels of experience” c.) providing a secure “harbor” of safety and support when the other partner is vulnerable and in core affect or a transient dissociation d.) creating sufficient safety in sessions to work through historical antecedents of trauma and deprivation in the company of and with the active support and often physical holding of the marital partner.
AEDP for Couples stands on the firm foundations of Accelerated Experiential Dynamic Psychotherapy (Fosha, 2000, 2010). In the practice of AEDP on a one-to-one basis, the therapist accompanies the patient somatically on a step-by-step journey through affective experiences that lead to transformational state-shifts of consciousness (Fosha, 2000, 2005; Lipton & Fosha, in press; Prenn, 2010; Russell & Fosha, 2008). The undoing of aloneness through resonant accompaniment enables the patient to side-step historical blockages and move through previously overwhelming affects all the way through to completion.
The healing of traumatic experience within the context of a safe relationship fosters deep repair and quantum change by accessing and occupying alternate neural pathways. From this healing comes new ways of being, feeling and dealing in daily living (Fosha, 2000, 2003, 2009a, 2009b). The patient dyadically works through embodied states of historically “burned in” defensive patterns that lie at the very source of the patient’s patterns of dysregulation both internally and in relationship with others. The patient can then access biologically driven adaptive action tendencies (Fosha, 2005) that provide corrective, creative and internally derived solutions that address the deep sources of dissociation and other forms of affective and relational disconnection. By facing previously unbearable states, the patient develops an embodied sense of verifiable trust (Mars, 2010) and new capacities to be deeply connected with self and other.
The AEDP therapist brings into awareness an expansive set of self-evolving resources within the patient herself that become accessible even in life areas never discussed in treatment (Fosha, 2009a, 2009b). Ultimately, the therapist becomes an internalized “true other” (Fosha, 2005) for the patient, who learns to freely access self-righting capacities in daily life.
The Clinical Practice of AEDP for Couples
The process described above for treating individuals with AEDP provides an optimal context through which couple members can cultivate the capacity to become a “true other” to each other (Mars, 2010). The longing to come toward one’s life partner and to successfully provide safety and security when the other is vulnerable and shaken is a highly satisfying and biologically driven imperative of attachment (Ainsworth, 1978; Bowlby, 1969). The treatment is an invitation for the relationship, first in session and then at home, to become the vehicle for a forward-moving evolutionary process that generates “earned security” (Roisman, Padrón, Sroufe, & Egeland, 2002) in both partners. They each come to provide a secure base for the other that affirms the deep longing to love and be loved in attuned and flexible ways that allow the life-partner to be different, and yet to be “let in” and to at long-last feel deeply accepted and valued for the differences each partner brings. As life-partners accomplish differentiation and mutual honoring in treatment, a cross-pollination takes place that generates natural, transformational forces by liberating the best, most loving and life affirming potentials of each partner’s lineage (Mars, 2009). The key to AEDP for Couples is the biological drive of transformance (Fosha, 2009a, 2010, Yeung, 2010). Transformance, most simply put, is the inverse of resistance. In sessions and in the lived life of couples, transformance is the drive experienced and expressed as the deep longing to love and be loved.
In AEDP for Couples, safety must be established first between the therapist and each of the members of the couple. When this safety then extends between the couple members in the intersubjective field that is cultivated within sessions, the transformative states AEDP fosters become available for the couple to hold, experience and share. Couple members learn to witness (Adler, 2002) each other in an increasingly somatically attuned way. This progressively growing embodied attunement creates the necessary safety to soften defenses and work through issues that predate their coming together in ways that bring justice and peace to even the most mundane of daily interactions. When between couple sessions, for example, the husband washes the dishes with a spirit of loving empathy for his deeply fatigued wife, rather than showing the accustomed resistance or resentful compliance or guilty submission, a deep level change has occurred in the relationship. This experience of being seen, remembered and responded to with the felt experience of love allows for such empathic attunement to become the new atmospheric condition of the home. Moreover, when that attunement is also informed by the husband’s reflective awareness of his wife’s history of feeling like a “thing made to do things,” the home becomes infused with a quality of corrective healing through deep reception of the other. This construction of new meanings (Tronick, 2009) that transform the mundane and menial tasks of lived family life into expressions of love and surprise infuses each member of the couple with new transformance strivings and re-enlivened eros that then potentiates and moves the next session forward.
A Challenge for the Person of the Therapist
In treating a marital dyad in the AEDP for Couples format, the therapist must track moment-to-moment and right-brain-to-right-brain the somatic and affective experiences of two people at one time. Furthermore, couple members almost always present contrasting attachment styles (Wallin, 2007) with accompanying differences in how each member experiences somatically in a relational context (Mars 2009). The therapist must provide a “bridge” (Mars, 1988) between the two couple members in which he recognizes, reflects and appreciates each member’s ways of perceiving, receiving and expressing somatically. Through the therapist’s affirmation and “translation,” each partner’s experience becomes increasingly accessible to the other couple member. Over time, the couple members learn how to decode the ways the other is accessing and then broadcasting his or her experience and then learns how to “bridge” to the other (Mars, 1988). This bridging capacity also transfers to the home life between sessions, allowing the couple to increasingly navigate their own way through otherwise “blind allies” of repeated misunderstandings to a new “growing edge” (Mars, 1988; Mindell, 1985) of mutual understanding, flexibility and compassion.
To do this bridging most effectively and naturally, the AEDP for Couples therapist must cultivate whole body “witness consciousness” (Adler, 2002) of perceiving, receiving and expressing in a wide range of “channels of experience” (Mars, 2010) at one time. This cultivation of self assists the therapist to transcend the defensive exclusion and limitations of his or her own internal working model. Then with these expanded capacities to perceive, receive and express somatically, he can provide the necessarily proficient and flexible conduit of “broadband capacity” (Mars, 2010) to track the intersubjective field in sessions in ways that match-up with both of the members of the couple. The therapist in the AEDP for Couples model then gently nudges couple members to go beyond the procedurally learned non-conscious “rules” of each of their internal working models to stretch to meet the other. There are seven “channels of experience” through which the AEDP for Couples therapist accesses and tracks the intersubjective field within sessions. Essentially the therapist tracks “bottom-up” perceiving, receiving and expressing via i. sensation, ii. emotion, iii. energetic awareness, iv. movement, v. auditory, vi. visual, and vii. imagery (Mars, 2009).
In the productive and necessary stretches couple members make in order to reach each other, they take themselves beyond their comfort level during sessions. By choosing to be consciously resonant with ways that are foreign to their previous life experience with its roots in their respective families of origin, couple members are imbued with a range of embodied experiences that are novel and undefended against. This then triggers core affects and other somatic experiences that “surprise the unconscious” (Main & Goldwyn, 1998). When the more avoidant couple member experiences the pleasurable core affect of love/joy in the foreground of awareness, a paradoxical “edge” is often triggered, of mixed emotional and somatic reactivity: one side for and one side against the experience. (Lamagna & Gleiser, 2007; Mindell, 1985) The vulnerability of the possible loss of that suddenly intensely felt love can trigger anxiety that may show up as an “out of no-where” background anger or dissociation. This paradoxical anxiety/anger/dissociation needs to be carefully tracked by the therapist and worked through in the session as it arises, and safely processed to completion, as an explicit and experiential unpacking of experience in the foreground of awareness. Meanwhile the other partner learns to become a compassionate witness to his or her partner’s process of exploring that previously non-conscious edge. The body-based sensations, tensions, energetic states, movement patterns that are uncovered in the exploration are often found to be linked to painful “lessons” of the past, when to dare to love was simply too dangerous or too unsupported. The role of the therapy is to work through to completion the historical roots of that anxiety and anger with the marital partner present as a loving and attuned other rather than being the sole target of reflexive enactments. The therapist serves a reliable, kind and capable stabilizing force who helps to structure a deeply reparative experience that directly transfers into the lived life of the couple and in so doing helps to expand the internal working model of both couple members to love and be loved, to deeply understand and to be understood.
The therapist must then do another round of metaprocessing and work through the mixed somatic and behavioral reactions that are elicited in the other partner who served as the witness during these successful, but often triggering “edge crossings” (Mars, 2010). This often results in vitality affects and tremulous affects, which when metaprocessed can set the scene for Core State experiences of relaxed flow in which fresh connections are made into the “unthought known” (Bollas, 1987) with remarkable ease and pleasure. As both couple members continue to expand beyond their internal working models, the therapist again must be sensitive to make room for all the dissenting voices of doubt, protest, rebound anxiety and all the somatic reactions that are stirred up that are “against” those changes being made, even if these changes have been invited for years. Paradoxically, this is especially true when the new loving experiences and expressions feel “sensible,” right and good at the time of the session. If the edges are detected by the therapist and processed to completion at the moment they appear as non-congruent somatic expressions as simple as shaking the head no, while smiling and enthusiastically saying yes, the new loving behaviors have a much greater chance to become resilient and stable at home. Unexplored edges are the sleeping non-conscious triggers for saboteur enactments driven by the return of the couple’s original interlocking internal working models that brought them into treatment. Fewer ruptures at home translate into verifiable trust being built that it is safe to love and safe to receive love non-defensively.
In summary, for each marital partner to cross-over to meet and satisfy the long-denied attachment level longings of the other to feel and be loved and loving, requires “rule violations” of both couple member’s internal working model. These experimental “rule violations,” while they can potentially generate enactments of betrayal of tender and tenuous trust, are also the very source of the “expansion of the loving behavioral and emotional territory” (Mars, 2010) that the treatment seeks to instill. It is the longed-for-love of the partner that is typically the sole motivation sufficient to take such stretches beyond the familiar (and in fact familial) survival strategies. The treatment is about acts of love. In truth though, most couples are driven into treatment by acute attachment anxiety. It is the movement from fear to love, from survival to thriving which is the expression of transformance: the motivating drive to evolve that gives AEDP for Couples its biological thrust and power as a treatment modality. As these new ways of perceiving, receiving and expressing love have been repeatedly, safely and explicitly unpacked and metaprocessed within the safety of the sessions, the stretches of new behavior become progressively more resilient and take up a stable residence in the couple’s daily life. It is a major theme of AEDP for Couples to create new shared territory upon which the couple incrementally and dyadically constructs a “new culture” and a “hybridized internal working model” (Mars, 2009) of relating to each other and to themselves.
In AEDP for Couples, the dyad is supported, catalyzed and scaffolded by the therapist so they can manifest a sufficient affective attunement with each other, so they can progress from defense to core affect. With softened defenses, the couple celebrates successes accomplished between sessions, makes repairs for regressions and moves through the blocks that showed up. As each wave of core affect is worked through to completion in sessions, adaptive action tendencies (Fosha, 2009a) come to the fore and organismically provide the emerging “next steps” in the couples treatment. For example, the follow-on effects of completing a wave of the core affect of sadness is seeking comfort that meets that felt-need-of-the-moment with that life partner instead of with the therapist. When anger is accessed and expressed clearly and productively with the marital partner, a much-needed setting of boundaries and an asserting in highly specific and adaptive ways takes place and is, with the help of the therapist, taken in by the partner. When the core affect of fear rises up in one partner, the other partner is helped to be present and come forward to offer the well-timed, attuned protection that at last matches the deeply felt core longing for what had “always” been missing, both in the marriage and in the developmental life that preceded it. As each session progresses and the natural expressions of each couple member’s affect are received as having meaning (Tronick, 2009) and value to be heard and responded to by the life partner and the therapist, confidence and resiliency builds within the couple. During these waves of processing core affective experience, the couple can physically hold each other hand-in-hand, body-to-body in ways the therapist cannot. The rightness of fit of the dyad is both confirmed and constructed through these deeply corrective and pleasurable experiences of close gazing, holding and expressing care and valuing.
AEDP for Couples is not a “manualized” therapy. The work is to evoke the authentic and spontaneous loving and attuned co-creations of the marital dyad. While all core affective experiences are important in the treatment, by far the most vital to the process in AEDP for Couples is the core affect of love/joy. The embodied experience of love is different from the idea of love or the memory of love, and certainly from the promise to love (Mars, 2010). The process of softening defenses and opening to the embodied experience of love for the other begins in the very first session in AEDP for Couples. This experience of love and the biologically derived inner direction that emanates from it, provides the guiding light and internal compass of the transformative process of each session and increasingly in the couples lived-life between sessions. Couples who are in the later stage of treatment describe middle-of-the-night interactions that had historically produced re-traumatizing arguments turning instead into surprising and deeply healing breakthrough experiences of finally getting through to each other and completing a process that had repeated itself as an unsuccessful turn-key enactment dozens of times before.
If the couple has children, the experience of the secure base they form in sessions comes to extend naturally to how their children feel them together. It has been demonstrated in recent research by the Circle of Security group that when a mother’s sense of security and attuned support improves, her baby’s status moves quite rapidly toward a greater security of attachment. (Marvin, Cooper, Hoffman & Powell, 2002). Also, improved teamwork in parenting results in increased stabilization and affect- regulation in the couple’s offspring. This then generates deep satisfaction and a primal confirmation of the couple’s rightness of fit with each other and of being on the right track and in the right relationship.
To read more of this paper, and if you are a therapist or intern,
view this pdf file
CAMFT Article 3 - 2018
The Felt Experience of Love is the Healing Force Tapped by AEDPfC