13. Acknowledging Respective Injuries - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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13. Acknowledging Respective Injuries

Therapist Resources > Therapy Books > DownRelRabbitHole- Assessment

Down the Relationship Rabbit Hole, Assessment and Strategy for Therapy
(to counter contempt in stage 4)

An individual may have trouble acknowledging his or her own pain and need help articulating it.  It may be because of cultural training (for example male stoicism) or from a family experience of needing to hide vulnerability from predatory family or community members.  An individual can be so involved in or avoidant of his or her own pain that he or she forget or cannot acknowledge another's pain, including that of a partner deeply committed to.  As a result, such an individual has trouble being or cannot be empathetic.  Or, an individual may have many experiences of having his or her emotions discounted or attacked.  Having feelings becomes a competition- an adversarial contest for survival.  When the therapist senses this dynamic in an individual, couple, or family, he or she can use a visual cue.  For example, on a small white board with a dry erase marker draw the following (adding additional elements to the first drawing until it looks like the last of the four drawings- or, duplicate the images and print them on hard copy and say,

"Some people think or feel that there's only room on the mountaintop for one set of feelings, one thought, interpretation, or perspective (draw on a rudimentary cartoon mountain with a human stick figure standing on the mountaintop).  Because they think there's only room for one (draw a couple of arching lines from the mountaintop towards the bottom), someone is always getting tossed off of the mountain!" (draw a human stick figure falling headfirst at the end of the arching lines).  At this point, often an individual or one of the partners or a family member might proclaim, "That's me!  Always getting tossed down!"  The other person, partner, or another family member may dispute that it's really him or her getting tossed, or one or both or more may proclaim that they take turns tossing and getting tossed off of the mountaintop to be crushed below.  The therapist can continue, "The problem is that sometimes you get tossed and sometimes you (the other person) get tossed.  In either case, your feelings or perspective is thrown into the depths… the depths of anger, loneliness, and despair.  And… inevitably whoever gets tossed down will begin to climb back up (draw a human stick figure crawling up the back side of the mountain) and get back at the one on top!  (draw a sword or stick in the hand of the climber).

An individual may act as if acknowledging the other person's pain diminishes the righteousness of his or her pain.  It becomes "My pain or your pain… only one can be!"  Each person, partner, or family member must be able to acknowledge the other's pain as being real and relevant along with acknowledging of one's own pain. This is critical to allow for healing.  Acknowledging ones pain can be a challenge since many cultures have strong sanctions against revealing that one has been injured- it is not "macho" for example.  In addition, noticing or pointing out that the other person has been injured, may in some contexts rather than of one being experienced as empathetic, have the effect of humiliating the other person.  An alternate approach focusing on justice- or right and wrong may be more effective if it is in line with the cultural expectations of the individuals.  The therapist may need to be the first to acknowledge each person's pain.  When the therapist can hold both or all persons' feelings as relevant, he or she can overtly challenge any emotional exclusivity.  "You don't need to deny the other person's pain for your own pain to be valid. Both of you have injuries."

While the process may be conceptually sound, it is often very difficult to activate with some couples therapeutically.  The emotional injuries are often accompanied by physical reactions.  Hicks (2004), "Physiology is a predictor variable of marital stability (Gottman, 1999).  Diffuse physiological arousal (DPA) is the body's response to perceived danger.  In this response, couples experience a reduced ability to process information, making it extremely hard to listen during DPA laden circumstances.  There is less access to new learning and greater access to habitual behaviors and cognitions.  In this process, fight-flight responses become more accessible and 'creative problem solving goes out the window' (p. 75).  According to Gottman (1999), it is vital for married partners to be able to ameliorate the 'fight-flight' response.  They must learn how to 'slow things down, restore calm, and refocus attention' (p. 77).  They must discover how to regulate 'strong blends of emotion.'  Not only will this 'soothing' of self and other facilitate more fruitful dialogue; it will also contribute to the physical and emotional health of each marital partner.  In sum, the core triad of alliance (behavior flow, perception, and physiology) has a bi-directional relationship.  This triad determines flooding which leads to the distance isolation cascade (mediated by the Four Horseman), which, in turn leads to distress and frequently dissolution" (page 99).  

Unless the therapist is able to interrupt the negative dynamic- that is, get individuals, the couple, or the family to interrupt their emotional cycling, therapy may get diverted to handling another common dynamic- an argument over who is the most injured!  Also known as the "Battle for the Most Oppressed" or the "Most Victimized!" as if the title gained some advantage.  This is a version of tossing the other off the mountaintop.  The one who claims the title of most injured also claims moral ascendancy over another- for example, his or her partner or other family members.   If one person makes this claim, the other person is or persons are often quickly drawn into the contest.  He or she has been emotionally annihilated and feel compelled to make the case for his or her feelings.  The first person experiences this as disputing his or her feelings and off they go… unless the therapist intervenes.  The therapist may need to assert the existential reality or experience of each individual is personal and not subject to competitive judgment.  There may be significant resistance to this, which then needs to be explored.  Cultural and family-of-origin experiences of emotional competition and "winner-takes-all" consequences in terms of power and control, status, access, and other so forth may underlie propensity to this dynamic.  

3056 Castro Valley Blvd., #82
Castro Valley, CA 94546
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
office: (510) 582-5788
fax: (510) 889-6553
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