18. AttachInjury ResolutionModel - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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18. AttachInjury ResolutionModel

Therapist Resources > Therapy Books > Out of Dev Chrysalis Intimacy/Relationship

Out of the Developmental Chrysalis in Intimacy and Relationship Therapy
by Ronald Mah

EFT proposes a seven-stage attachment injury resolution model for therapy.  During stage one the therapist works to de-escalate the couple.  The therapist prompts the partner with a grievance to risk the availability of the transgressing partner.  He or she does this by bringing up a specific incident where he or she felt the partner violated the trust inherent in the relationship.  This is recounted with a great deal of emotion and passion, which may or will cause the accused partner who may have been momentarily emotionally available to withdraw again to protect him/herself.  For example, Ginger brings up the school picnic.  She had taken the kids and gone early to help set up.  Benjamin had to come from work.  He was supposed stop home and pick up the table decorations and their contribution to the picnic- individually decorated cupcakes with each child's name on it, and then meet her there.  Something had come up at work and Benjamin got involved and had forgotten.  He didn't realize he had blown it until she called fifteen minutes after he should have been there.  It took him another 45 minutes before he got there.  "And he acted like it was no big deal… he makes his entrance like he's walking the damn red carpet at the Academy Awards!  Doesn't even apologize… just drops the stuff on the table.  'Hi honey,' and starts being Mister Bigshot Fun Guy!  I'm scrabbling to set up the decorations.  And of course, he had forgotten some of the cupcakes!  I'm humiliated and just seething!"

The betraying partner may respond with denial, minimizing, or dismissing entirely the hurtful incident.  He or she may be hostile and distant without relating to the experience of the hurt partner.  Benjamin listened attentively to the Ginger initially, especially with prompting by the therapist.  As Ginger built up momentum and anger, his jaw began to set.  He sighed and rolled his eyes.  Benjamin interjected, "What was I supposed to do?  Just blow off my boss?  Where do you think the money for the cupcakes come from?  Or your new car?"  Ginger responded, "You do this all the time."  Benjamin countered, "It wasn't that big a deal.  I was a little late, but half the people weren't even there yet… and hardly anyone was eating yet.  Cupcakes are for dessert anyway."  Ginger said almost crying, "It was so embarrassing.  I had to wipe the names off the cupcakes… make them 'ordinary' cupcakes so the kids who didn't have cupcakes with their names on them wouldn't be disappointed."  "Hey," Benjamin chimed in cheerfully, "No one knew.  No harm, no foul."  With a death stare, Ginger spit out, "And what about the hour and a half I spent on writing the names in frosting?  Typical."  Benjamin groaned, "See what I have to deal with?  Making a big deal out of a small mistake."

Johnson (2010) says that studies on attachments between mother and child and of adult love that "in secure relationships people can become aware of and regulate their attachment emotions, accept their needs and express these needs coherently and openly to the other."  If Ginger and Benjamin were secure, they could accept comfort from and offer comfort to each other.  They would use this sense of felt security to take on the challenges of the rest of their lives.  The therapist needs to guide them towards healthy patterns of engagement and trust (Johnson, 2010).  The following is a list of some potential EFT interventions and therapeutic interactions.  The therapist can see how these therapeutic activities may be similar to what is suggested from other theories/therapies the therapist is familiar with.  

Validation is used to create a safe haven in the session for both partners.

Emotions are tracked, unpacked, and tied into key steps in the couple's drama.

Responses are framed and clarified within the new understanding of attachment.

Profound, core emotions are heightened and evoked to move partners into new more responsive interactions.

New enactments are shaped to help partners move into interactions where each one of them can reach for the other and respond caringly to the other (Johnson, 2010).  

The therapist encourages the partner to stay his or her feelings during Stage 2 to help him/her go beneath anger to the deeper hurt, fear, and shame of the attachment injury.  The continuing emotional influence of the injury is connected to the current negative interactional cycle.  For example, Ginger may be guided to express her frustration and hurt, "Ginger, you didn't get his attention.  Tell Benjamin what happens to you when you're not getting his attention."  Ginger might say, "It's so frustrating.  I keep on pushing at him to get him to pay attention, so he doesn't won't just act like it's all honky-dory."  The prompt helps the injured partner experience at a greater depth while also being less overtly hostile.  Depending on the therapist style, the partner can be validated, deepened, and guided with a simple statement, interpretation, or reframe, "You must feel sad wanting but not getting Benjamin to feel you.  Is that right?  Say some more about how you feel."  "With both withdrawers and blaming anxious partners, the therapist helps them move into a deeper connection with their own fears and longings, and then express these fears and longings to their partner in a way that pulls the other close" (Johnson, 2010).

During Stage 3, the therapist supports Benjamin, the hurtful partner and makes it safe for him to hear Ginger's pain.  When the first partner's experience of the harmful or hurtful behaviors have been framed as an attachment injury, it becomes easier for Benjamin to gradually move towards Ginger.  Ginger's reaction is seen not as Benjamin's messing up or being messed up but instead as indicative of how important Benjamin is to Ginger.  This can make Benjamin less defensive and more able to acknowledge Ginger's hurt.  The therapist can be as overt as telling Benjamin, "Instead of her saying you're an asshole, she is saying you're that important to her.  Reaching out to and caring for her isn't an admission that you are the asshole, but that you really do care."   Benjamin can recount how he experienced things as they happened while being prompted to take ownership for his actions.  This deepens the experience for both of them as they move into Stages 4 & 5.  Benjamin moves from an adversarial position into a cooperative partnership with Ginger.  

In Stage 4, the therapist continues to help the harmed partner express his or her attachment injury feeling vulnerable and sadness from the fear of loss of trust and of the attachment bond.  For Ginger, this may be talking about her loneliness from not having been able to count on important intimates throughout her life.  There may be stories about being the new kid in class, being ostracized and bullied by the mean girls in middle school, or being dumped by her older siblings at a social function.  It may be about her emotionally unavailable father.  The grief, loss, and fear may be echoing old experiences of being abandoned… again.  "…the therapist succeeded in de–escalating this cycle by uncovering and explicating the emotionally laden issues associated with antecedent attachment needs stemming from their childhood working models (e.g., lack of responsiveness of (her) father…)" (Naaman, et al., 2005, page 68).

At any part of the therapy but especially in the beginning, negative cycles of interaction need to be broken or de-escalated.  Connecting current emotional distress to familial or other historical antecedents both serves to take the focus off each other, but also help connect the attachment "dots."  As Benjamin experiences Ginger's vulnerability, during Stage 5, it's safer to connect and own his part… to own his responsibility for her attachment injury.  It may be spontaneous or the therapist may prompt the offending partner to express his or her emotions of regret, remorse, and empathy.  "Did you know it went this deep for her?  How do you feel about Ginger's hurt?  Let her know."  Benjamin may be able be responsible and most of all, express his caring.  He may make an apology.  Saying "Sorry" becomes not an admission of guilt, but an expression of care.  The offending partner's expressions are affiliative and mutual deepened experiencing.  Since Benjamin has re-engaged at Stage 6, Ginger can risk "asking for the reassurance and comfort that was unexpressed at the time of the injurious incident.  The level of experiencing reaches a peak at Stage six for the injured and offending partner… the injured partner has a response of friendly and the offending partner has a response of affiliative," (Naaman, et al., 2005, page 64).  As therapy and the relationship progress, at Stage 7, Benjamin now responds to Ginger with caring and protective energy, restoring trust and healing the attachment bond.  Johnson (2010) has described this as a felt sense of connection and as... "the neural duet… of mirror neurons firing in the brain so that we feel within our bodies the moves and emotions of another... a state of resonance."  Physicists speak about two particles that vibrate together, coordinated in a "natural synchrony of matching rhythms and responses, where intentions and moves are transparent and perfectly anticipated."  Such engagement occurs between parent and child and between connected adult partners.  Johnson says, "This is perhaps the essence of love."

"When couples can reconnect (or even connect for the first time!) in this way, immensely positive bonding events take place.  Partners begin to see each other more fully and are more authentic and compassionate with each other.  Their connection empowers each of them and opens the door to all the benefits that research tells us comes with secure attachment.  Their way of engaging with their own emotions, their loved one and the world, which now contains a safe haven, shifts.  The research on bonding suggests that as they make this kind of connection, lovers are likely flooded with the cuddle hormone, oxytocin.  This is released during orgasm, breast-feeding or simply when attachment figures come close to us.  Oxytocin is also linked to the release of dopamine, a natural opiate linked to pleasure and down-regulates cortisol, the stress hormone.  The neurochemical basis of bonding--the physical source of the calm euphoric feeling associated with love--is no longer a mystery.  Once a couple can create these kinds of interactions, they can move into the final consolidation phase of EFT" (Johnson, 2010).

"Both partners are now encouraged by the therapist to construct collaboratively a new narrative of the event. The manner by which the offending partner came to respond the way she or he did during the injurious event needs to be integrated in the narrative in order to be acceptable to the injured partner" (Naaman, et al., 2005, page 64).  The therapist can ask, "Ginger… Benjamin… what happened with you two?  What did you see?  What did you want?  What did you do differently?  Why?"  The therapist can reinforce their process by prompting awareness of their attachment styles and injuries and their soothing and self-soothing behaviors.  "What is hard for you?  What did you get from your partner that worked?  How was that different from what you experienced before within the relationship and as a child?  How do you take care of yourself when your partner can't do it all or isn't around?"  The new narrative replaces or is the evolutionary descendent-therapeutically enhanced and advanced of the old narrative of attachment injuries and problematic relating.  As the story of positive interactions is articulated, as individuals and as the couple, they become more able to quantify the behaviors that attend to and satiate each partner's emotional needs.  As they can quantify the behaviors, they become available to each other and more able to replicate the behaviors when qualitatively similar emotionally anxious circumstances arise.  The story of the relationship gets to have altered endings that they can choose using the strategies and tactics developed with the help of therapy.  

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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