Helping Couples Heal From the Trauma of Disclosure Everett Bailey, PhD Stacy Hall, LPC

“Trauma, particularly trauma inflicted on person by another, constitutes a violation of human connection” (Herman, 1992)

“Couples recovery explained more of the variance than any other factor in accounting for recovery” “Sex addiction is an intimacy disorder. The inability to be vulnerable, to trust anyone due to attachment injuries” (Carnes, CSAT training)

“The essence of healing the ‘violation of the human connection’ is the creation of the secure bond with a significant other. This other can then provide a safe haven and a secure base for lifelong learning and growth” (Johnson, 2002)

1. Safety and Stabilization 2. Coming to Terms with Traumatic Memories 3. Integration and Moving On  Safety & Stabilization: create physical, emotional safety, let them know what to expect, give them a plan Psycho-education, sobriety contract, boundaries, treatment plan, accountability plan, polygraph, 12-step, sponsor.  Coming to Terms Help clients “metabolize” trauma. Emotionally process the anger, hurt, fear and shame from the disclosure.

 Integration and Moving On Put trauma in context of couples interactive cycle. Help couple learn from this. Help them to develop a greater capacity for healthy attachment by changing the couples previous negative interactive cycle.

Trauma Related Responses:  --Intrusive Re-experiencing: Nightmares, flashbacks, intrusive thoughts, powerful emotions.  --Numbing and avoidance: Restricting affect and attachment from others. Avoidance of trauma triggers.  --Hyper-arousal: Sleep disturbances, hyper- vigilance and exaggerated startle response. Extreme anger and irritability.

 Trauma survivors often oscillate between angry critical outbursts (FIGHT) and frozen numbness (FREEZE) or paralyzation-withdrawal (FLEE).  Normalize and affirm all of these symptoms in early stages.  Hyper-vigilance is an appropriate reaction to loss of safety.

 Obsessive thinking isn’t a pathological response to trauma. In fact, it’s very normal.  The irony of healing from infidelity --Other is danger, so contact is a source of fear. Other is safety, so contact is the solution.  Van der Kolk and colleagues state that it is the ability to derive comfort from another human being that ultimately determines the aftermath of trauma, not the history of the trauma itself.

 Defensiveness  Anger  Withdrawing, avoiding  Stonewalling  Want to move on, not dwell  Lack of empathy  Feels one down  Negative view of self  Self doubt  Guilt and shame

 Feel heard and understood  Answers to questions regarding the affair  Reassurance from the OP, providing concrete evidence of current faithfulness  Experience the OP as understanding and deeply empathizing with the pain of the IP  Owning responsibility for the betrayal and genuinely being remorseful  Experience the OP as accessible, responsive and engaged

 Provide IP with answers to her questions in a non-defensive way  Give reassurance and evidence of faithfulness  Accept consequences for their behavior  Take full responsibility for their behavior  Go through apology process  Have accountability to IP and others  Exhibit victim empathy  Process their shame, guilt and other emotions

1. Have clients talk to the therapist, initially. 2. Help clients identify and express primary emotions. Hurt for the IP and fear for the OP before sharing. 3. Healing happens as clients express affect in attachment related terms. 4. Reframe partners behavior/emotion in terms of attachment need. 5. Give couple corrective emotional experience 6. Healing from trauma is state dependent. Where in an emotional state of hurt/fear they are able to turn to the other and experience them as a source of comfort and support. I am not alone.

 Her healing is feeling like the offending partner (OP) is available and accessible to her hurt.  When his shame interferes with him being accessible, she continues to feel unimportant and like her needs don’t matter.  The repair work is in feeling like he HEARS her and that he’s accessible, responsive and engaged to her feelings and needs.  This will provide her with the safety to continue sharing with him and rebuilding their trust.

 Lean into her anger and validate it to bring down reactivity.  Have IP talk through the therapist at this stage as a way to soften her rage.  Important for IP to express emotion, including anger, to partner without being out of control/raging.  The skill comes in learning to de-escalate her reactive anger and share from more vulnerable place.  Extent of her anger is the extent of her pain. Get her to connect to the softer emotions is essential for healing.

 When IP is repeatedly triggered:  Have her write down any questions in between sessions that come up and share in therapy session.  Couples can predict situations that may evoke triggers and talk together about how they can handle them as a couple.  When she’s triggered, process of learning to turn to him and share that she’s triggered and talk about her fear and other emotions.  This will set the groundwork for the OP to be more accessible to validate her and not get defensive.

 Help him to be present and accessible to hearing her share her anger and other emotions.  Acknowledging/validating her anger and have her talk through therapist until she is less reactive and ready to present to partner.  Have the couple work as a team to predict what might trigger her and how to soothe her.  Work with IP toward sharing her more vulnerable emotions when triggered.

 IP’s distress, anger, and pain triggers OP’s shame  Help IP process the shame  “What goes on for you when you see her anger/pain?”  “It is so difficult to see her pain”  “you just want her to see you as a good person again”  “you wonder if you deserve to be forgiven”

 Help IP identify the primary emotion of fear, underneath the shame and connect it to the attachment need of losing the relationship  What is that like when you see her anger and wonder if she can ever forgive you and trust you again?  I wonder if there is a part of you that is afraid if she doesn’t forgive you she may leave the relationship. And that is the last thing you want to lose her because she is so important to you.  Do you ever tell her that? What would that be like to tell her how important she is to you?

 We are helping them to develop a felt sense of security and safety that gets them to reach to each other. Clients will not do this on own naturally.  Therapist is actively working to construct these changes in the session and helping her learn to reach to him in a non-blaming way when triggered.

 The 8 Steps to Healing Attachment Injuries: Sue Johnson, Ph.D.  1) IP articulates injury and emotional impact.  2) OP discounts and minimizes taking defensive stance.  3) IP access attachment fears and longings.  4) OP acknowledges the partner’s pain and suffering.  5) IP ties the injury to the loss of attachment bond.  6) OP acknowledges responsibility and engages.  7) IP asks for reparative comfort and caring.  8) OP responds in caring manner.

Key Steps:  Going through these steps again and again.  Need to process the fear of reaching/sharing vulnerable emotions.  Need to help both the IP and OP get down into their primary affect:  -Reflecting and validating primary affect.  -S-L-O-W ing down process.  Use attachment related language.  -Help them connect with emotions in body.  - Give clients some of the language.

Examples of Accessing Primary Emotions:  “As you sink into this, what’s happening right now inside for you?”  “You don’t look frustrated, but sad. Does that fit?” “There is so much happening inside of you right now. Can we slow down…can you notice what’s happening in your body.”  “You try to manage all these feelings, you don’t show them to him?”

 Scaffolding here is important. Therapist holding the process until it’s safe for clients to turn to each other and share from this raw and vulnerable place.  As going through this process, trying to elicit a felt sense/response. Going SLOW is important here.  Tell OPs: “We are building the foundation of trust and each time you can hear her is another brick in that foundation.”

 Please review the following appendix slides for further information on repair work.

 As we are processing the disclosure injury, it’s common for couples to hesitate or be fearful of sharing vulnerable with their partner.  Important to spend time processing these fears of being vulnerable and how scary this feels. Client can start slow by just sharing about how risky it feels to share.  As we DISARM FEAR OF REACHING they will feel more safe to be vulnerable. This vulnerability will then come forward naturally.

 It can be helpful to give clients some language.  Therapist might ask “what are you telling yourself that’s getting in the way of reaching to him?” “What would it be like to reach to him?”  “I can’t imagine sharing these emotions with you. It’s too scary to share this with you.”  “I’m terrified to let you in.”  “I don’t know what it would be like to turn to you for comfort.”  “So terrified and I just need your reassurance.”

 What often comes up in this process of addressing trauma of disclosure, there are particular attachment needs that haven’t been met. IP can share these with her partner.  Examples:  “I’ve felt so lonely and unimportant not getting your attention.”  “Felt like I didn’t matter to you. I need to know I matter and that you care for me.”  “I’ve felt so abandoned in this marriage. I need reassurance and comfort.”

 Johnson, S. (2002). Emotionally Focused Couple Therapy with Trauma Survivors: Strengthening attachment bonds. New York: Guilford Press.  Johnson, S., Makinen, J. A., & Millikin J. W. (2001). Attachment injuries in couple relationships: A new perspective on impasses in couples therapy. Journal of Marital and Family Therapy, 27,  Herman, J. (1992). Trauma and Recovery.  For more information on Emotionally Focused Therapy go to their website