The therapist may also take a role as a facilitator, which may be related to the referee role. A facilitator role promotes communication, negotiation, intimacy and/or any other process that leads to behavior change. The therapist in this role may limit or withhold entirely any interpretation, insight, or suggestions. The individual, couple, or family is assumed to have the basic ability to function effectively and/or have the basic skills to function well. Similar to how sessions with personal trainers facilitate exercise for greatest efficiency and effectiveness, therapist as facilitator in therapy try to move the process along without necessarily taking an overt role. Facilitating catharsis, for example may promote growth. "In psychotherapy, (catharsis) has been understood to mean an approach for lowering tension by releasing unexpressed or unconscious emotions… For Freud… catharsis was a process in which recalling and expressing forgotten memories result in a feeling of relief… Freud focused on the cognitive side or catharsis… catharsis has two separate components: 1) cognitive catharsis, the intellectual recall of forgotten material and the sharing of that experience and talking about feeling, and 2) somatic-emotional catharsis, the physical discharge of emotions that may entail angry yelling, tears, laughter, or other physical expressions… evocative procedures…help family members be more in touch with their inner experience and feelings in order to get rid of the emotional sterility that is so pervasive in dysfunctional relationships… catharsis may be effective because it interrupts old patterns of emotional suppression, thereby eliciting previously unconscious feelings and leading to the cognitive connection of those feelings" (Durana, 1996, page 272)
Somatic therapies, role-play, Gestalt work, and primal scream therapy are but a few approaches based on catharsis oriented theories and therapies. Catharsis however may otherwise foster inactivity by stressing getting rid of feelings without creating behavior change in the present. There may still be underlying problems that caused the strong emotions resulting in the cathartic release. While the "cathartic fix" reduces tension and may feel good, it may not be a healthy way to release the tension or feelings and the underlying issues remain unchanged (page 278). For example, Earl got out his stress from deep feelings of powerlessness from his childhood, in his marriage, and at work by playing sports, but the feelings always returned because he never addressed his underlying issues. Getting it "out of his system" periodically was just enough to convince him that he did not need to deal with his life distresses. As a result, his marriage gradually deteriorated and his resentment about life gradually increased over the years.
Mirroring can be an appropriate compatible or alternative strategy for the therapist. Mirroring back to another is a fundamental communication of connection. Parents mirror their babies' expressions and babies mirror parents' expressions. The reciprocal validating attention connects them to each other securely. Individuals experience similar connections when they engage in behaviors that enhance healthy relationships. If disconnected and feeling isolated, a partner or family may try to get the other person's attention. Unfortunately, attempts to gain attention may be problematic and cause greater disconnection. The therapist may need to facilitate specific behaviors to ask for and to give attention. One of the best ways may be to have the individual simply to mirror another's feelings and thoughts. More structured ways give and get attention may also be necessary, such as having dates, setting times to talk, and otherwise making scheduled time together a priority rather than the getting leftovers (which is often non-existent) time in life's scheduling. Therapy may include interpersonal communication training and behavior negotiation for less adept clients. Connection occurs when individuals feel their communications are heard. When heard, one feels that they matter to the other person. Each person counts and the relationship counts. Everyone's energy, work, skills, and experiences become valued resources for the relationship. When an individual feels unvalued by a significant other person, he or she may try to retaliate- to seek revenge for the betrayal. Betrayal is relevant because the implicit covenant of the intimate relationship requires being treated as not just valuable, but as being special. Instead of a relationship of reciprocal loving and giving, it a relationship of grievance, resentment, and hurting. Instead of mirroring valuing of the other, individuals reflect anger and ugliness.
Some individuals with significant history of being disconnected and discounted may internalize that identity. The therapist needs to explore this possibility with both Carson and Vee. They may anticipate that others (including the therapist) may not connect with them and will treat their feelings, thoughts, and experiences as not counting. Unable to get positive energy reflected back to them and unable to reflect positive energy to their important others, such clients may desperately need the therapist to "get" them. As a mirror, the therapist reflects back feelings, thoughts, and behavior to the individual and to each one in the couple or family. This may be powerful enough for some clients to trigger catharsis. Feedback is variations of this basic communication- "This is what I see. This is what I heard." As an effective mirror to a client, the therapist not only reflects back to that individual, but also in couple and family therapy reflect with therapeutic amplification to the other partner or family member the feelings and thoughts of that individual. The therapist should mirror with judicious interpretation and emphasis, perhaps translating the first individual's feelings or thoughts into the culturally familiar communication and context of the other person. This gives the other person an opportunity and training to mirror the speaker, while validating the speaker's emotions and experiences. The therapist's behaviors and hopefully, the other person's responses nurture the first individual's emotions.
Emotionally Focused Therapy is one of many therapies that encourage nurturing emotions. EFT as a form of couple therapy integrates experiential and systemic approaches in the process of therapeutic change (Peluso and Macintosh, 2007, page 250-51). "Through unveiling the shrouded emotional needs and identifying negative interactional cycles that maintain each partner's interactional stance, these interactional patterns can begin to change… Not only is the expression of needs facilitated, but there can be the creation of new responses on the part of each partner… emotional expression and communication are primary forms of self-regulation which enable people to identify that which is important to them and to their partners, thus allowing couples to meet each other's emotional needs better. Emotional expression is also a regulator of behavior both toward oneself and one's partner" (page 251). If the other person or the therapist fails to mirror the individual, it becomes unsafe for the individual to reveal emotional needs, that is, to become emotionally vulnerable. Hesitancy to express emotions curtails opportunities to learn new more productive responses. The therapist in couple and family therapy needs to not only mirror to each individual, but also to the couple or family as a unit. The therapeutic intention is to have the individual, couple, or family see the dynamics they may have otherwise missed by being too immersed in them. By seeing their dynamics in the therapist's mirror, they are encouraged to recognize the relative functionality of their choices; or recognize how ugly their behavior may be; or recognize to their chagrin how it replicates their families-of-origin. Mirroring increases awareness, and this facilitates change in individuals, couples, and families.
Mirroring alone however may not be sufficient for some clients. The therapist may choose more structured and directed interventions for individuals, couples, or families with more negative and rigid cycles of relating. In enactments for example, partners may be prompted to try different communications (which may include mirroring actions). "Softening is a change event that represents a shift in the negative interaction cycle where partners are more emotionally accessible and responsive to each other… As partners soften towards one another, they become increasingly willing and able to reach out and ask for comfort, safety, and security, thereby enabling them to renew their attachment bonds and interact with greater openness and softness… Enactments allow the therapist to structure, facilitate, and coach couple interaction directly rather than channeling the clinical narrative and interaction entirely through the therapist… carefully crafted enactments address and resolve couple distress in terms of core attachment and self-concept needs, threats, and longings" (Andersson, et al, 2006, page 302). Interventions such as enactments, prompt individuals to interact with each other with the therapist facilitating appropriate boundaries for safety and attempts to understand and reflect feelings and intent. Enactments can be adjusted depending on the level of relationship reactivity and volatility. At the beginning of therapy, when the individual, couple, or family may be the most negatively activated, therapy may need to be more structured. Most of the communication in couple or family is done through both partners or all family members talking to and through the therapist rather than directly to each other. Carson talks with the therapist. Vee talks with the therapist. And, the therapist speaks to each of them for the other. This serves to minimize negativity that might ignite them. The therapist can listen, comment, and mirror with empathy for the feelings of each individual (rather than try to have the individuals mirror each other). Feedback may include boundaries, interpretations, and directives but always with compassion for the emotional experience of each individual.
This can serve by softening one or both partners, or multiple family members. Softening reduces resistance and increases individuals' abilities to express with less hostility. While still upset and possibly still angry, individuals who feel connected to the therapist have greater receptivity to being guided in expressing their issues. In feeling heard, individuals can speak more about the underlying attachment and self-esteem issues that their anger and behavior are expressing. The art of therapy often happens when the skilled therapist gets connected to the individual, and in couple and family therapy to each individual despite having two or more highly reactive people who still do not get one another. As the therapist "gets" them, the interpretations, prompts, or other interventions can reduce their reactivity and eventually, catalyze relationship connection. They feel that their feelings and experience count to their therapist and eventually, to each other. Or, can be or should be to others in their lives. This can cause them to feel more connected. When they "get" each other, they soften and shift from negative interaction cycles. The therapist allows greater relationship autonomy in therapeutic interactions and communications as they soften and become more connected. More volatile relationships are served by greater therapeutic structure, clear roles, and modeling of appropriate communication. Less reactive relationships and those that have progressed significantly may not require such structure and control by the therapist.
Lee (2005) literally puts the therapist next to clients to elicit their feelings and thoughts. With a couple or family, the therapist becomes the "double" of one partner or family member and then another. Gestalt therapy does something similar in the therapist voicing one or another persona of the individual client. The therapist attempts to merge with an individual and offer a voice to what he or she feels or thinks, "…by assuming the posture, the position, the point of view of another person—sitting beside or slightly behind that person and trying to see the world through her/his eyes. When the double speaks, it is in the first person, imagining what the protagonist, the person in front, may be thinking. That is a hypothesis offered for two purposes: one, to correct or expand the double's understanding and two, to encourage the protagonist to be more expressive and exploratory… After the double speaks, the protagonist restates the theme in his or her own words, correcting and expanding as appropriate. The protagonist always has the definitive last word in response to a double's hypotheses. A double is successful when the protagonist says more than the double says. When the double says twenty words and the protagonist says three, or one, such as "yup," or "right on," then the double knows that he or she is doing all right. However, if the double is not helping the protagonist to produce more that will then correct or enhance the double's understanding, then the double is not meeting the other objective, which is to encourage the protagonist to be more expressive and more exploratory" (page 112-13)
Clients often need to hear their own voice saying something to discover if it is the truth. However, they may not be able to articulate their feelings or thoughts well enough to try them out verbally. A therapist who acts as a coach double "put words into his or her mouth" for an individual to "taste" the communication. The skilled and intuitive therapist may be able to intuit or guess the feelings and thoughts and offer words to a client to express. If done gracefully and artfully, a client will not feel forced or coerced to owning words that do not fit his or her feelings or thoughts. Prompted skillfully, a client will feel the truth or not as he or she repeats the words. Such a process bridges the client's inarticulate internal process that has been frustrated in getting out to connect with another person. This may be particularly important if gender stereotypes are relevant. If Carson as a male is not emotionally verbally articulate, or, if Vee expresses emotionally while losing logical clarity, their connection may need assistance. Speaking for the individual may allow vulnerability to be offered and both the speaker and the recipient may soften and feel more connected. Softening also occurs when people can find the humor in their process. Bazzini et al (2007) found that "those who engaged in the shared humorous activity reported greater feelings of closeness to their laboratory partner than those who had engaged in a task that did not involve humor. If the sharing of humor and laughter can directly influence perceptions of closeness to a stranger, it stands to reason that similar benefits may be derived within relationships of a more personal nature. In the case of romantic relationships, increases in feelings of closeness following a humorous experience that evokes laughter would likely be evidenced by reports of heightened relationship satisfaction" (page 26).
Bazzini et al believe that in sharing humor, people include each other's perspectives. They gain something from each other from appreciating something in common. Discrepancies in what they find humorous are moderately to negatively correlated to attraction to the partner (page 26-27). Reminiscing about humorous shared events creates greater connection between partners. They feel "that they possess a potentially unique perspective of given circumstances. Shared jokes, nicknames, and life experiences have been incorporated into… 'a secret language' that serves to enhance the bonds of the relationship" (page 32). Couples who responded to each other playfully and enthusiastically during a 10-minute interaction during dinner predicted how much they used humor when in conflict. Couples may create as reservoir of positive experiences and results that they draw upon in subsequent conflict situations, or accrue negative experiences that create higher vulnerability to repeat negative interactions. "When couples savor events that have previously created mirth and shared laughter via collaboratively reminiscing, they appear to be making meaningful contributions to the balance of positive and negative outcomes in a relationship that ultimately affect relationship stability and longevity" (page 33). When a people laugh over something, they mirror to each other their enjoyment of the joke or silliness and their affection for the other who shares the humor. Humor can also be an effective strategy to release growing tension between individuals in a couple. The therapist observed a Rick and Alta- a couple with terrible communication skills gradually get more and more frustrated and angry at each other. Insinuations turned into outright accusations. Implied slights became overt name-calling. Within barely one minute, they ended up facing off with mutual death stares. The therapist was getting tense! Suddenly, Rick said with a hint of a smile dancing on his lips, "So now is when we either strangle each other to death, or have sex!" Alta snapped back, "Sex with you is like screwing a dead man anyway, since you can't keep it up!" The therapist tensed up even further. How would they take this from each other? Was it biting sarcasm… some mocking humiliating attack? If so, the session was going to go down the drain quickly. Orathinkal and Vansteenwegen (2006) in identify that "Ridicule is a ''big gun'' and is an especially effective weapon for taking psychological space from a rival. Psychological space, the influence that an individual exerts over the feelings and thoughts of others, depends on his being taken seriously as well as being able to command attention. Ridicule effectively undermines these foundations of psychological space. Joking/ridicule is a dangerous technique in marital relationships" (page 38).
Then… Rick and Alta both burst in uproarious laughter and the tension immediately dissipated… and the therapist was amazed! It wasn't ridicule. It was sarcasm, but received as funny. Rick and Alta had probably the worse communication skills of any couple the therapist had worked with, but they also had humor to break the tension when it got too hot and scary. Instead of further intensifying and diving into the deeper nasty words and behavior that would destroy their relationship, they laughed at themselves for their over-the-top words and behavior. The therapist with a humorous personal style may often start therapy with some playful banter, which includes teasing the individual, or one or both of the partners or family members. And/or the therapist may tell a joke on him or herself. If the individual, both of the partners, or all family members smile or laugh (mirror the therapist's playfulness), a reasonable therapeutic assessment is that the individual or the members may still have enough vulnerability to share humor or share humorous perspectives. This tends to make for more positive outcomes in therapy. If the individual, or only one or neither of the partners or members smile or laugh, then the therapist may be already sensing that the depth of pain and disconnection is much greater. Therapy and healing individually and mending the relationship will be that much harder.