4. Facilitating Vulnerability - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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4. Facilitating Vulnerability

Therapist Resources > Therapy Books > DownRelRabbitHole- Assessment

Down the Relationship Rabbit Hole, Assessment and Strategy for Therapy

Being vulnerable, that is revealing inner or deeper feelings may be something that each individual, couple, or family may be somewhere from highly comfortable and familiar to completely distressing and foreign.  The therapist for example, may find many men for whom being vulnerable violates their fundamental "man codes" of self-denial and stoicism.  Or, the therapist may encounter women for whom silent suffering is expected, while overt expression may have been punished.  These values and behaviors can be from experiences and modeling from family dynamics including the alcoholic family system to various conscious and unconscious cultural models, including religious values.  Individuals self-define based on what they have learned or not learned, been rewarded or punished to approach or not approach life and relationships depending on core experiences.  Gore (2006) said, "How people develop and maintain relationships depends upon how they have defined and constructed the self.  If individuals primarily define themselves in terms of close relationships, then they will seek to develop and maintain close, harmonious relationships" (page 97).  The therapist, for example may find some clients (or one of the two partners) to be very willing and ready to be vulnerable in couple therapy.  This may be the family process that such clients will default to under the stress of the relationship not working.  "...people with highly relational self-construals tend to disclose intimate information even when the initial assessment of the relationship is not entirely positive.  This suggests that people with highly relational self-construals are looking for ways to improve their relationships even in the early stages of development" (Gore, 2006, page 97).

Client willingness to express vulnerability or to be trusting may in of itself be a part of the assessment process.  The early entry to therapy, relative to individuals, couples, or families who endure years of toxicity and only come to therapy in crisis, may be indicative of a relational style (for at least one member of the couple or family) that includes sharing vulnerabilities.  Early revelations of vulnerability in therapy by one member may also be revealing this.  Depending on the style of the therapist, he or she may not only use the offered vulnerability for assessment and developing rapport, but also begin therapy by asking an individual of his or her expectations of other's response to expressed vulnerability, how the vulnerability process affects another, the other person's verbal and behavioral responses, how the first person interprets the response or lack of response, and so on and so forth.  Behaviors, expectations and interpretations may have gender distinctions.  Hasselbrauck (2002) presents a four-factor structure of the prototype of relationship quality: Intimacy, Agreement, Independence, and Sexuality.  Women score higher than men on the intimacy factor.  They tend do more intimate self-disclosure than men.  Women also enact more intimacy behaviors such providing emotional support.  Despite gender differences in behaviors, for both men and women there is similar strong belief in the importance on intimacy in the relationship.  Men tend to find maintaining harmony as more critical to the relationship than women.  Not surprisingly, they also tend to be more conflict-avoidant (page 260).  In each study Hasselbrauck examined, intimacy consistently received the highest ratings and showed the highest correlations with relationship satisfaction across countries and across sex (page 267).  "...fundamental human needs that are likely to be fulfilled by the kinds of behaviors and interactions depicted in our intimacy factor.  For example, the features that received the highest loadings in our factor analyses were: taking time for each other, talking with each other, empathy, listening to each other, taking interest in the partner, consideration, and so forth.  To the extent that a relationship is characterized by these kinds of interactions, the relationship is likely to be construed as exemplifying the prototype of relationship quality and to be judged as highly satisfying" (page 267).  Assessment of the couple could look at the quantity and quality of these features.  Low quantity or poor quality of these features could be interpreted as related or possibly causal of poor couples relationships.  Therapy in general, and couple and family therapy in particular may direct treatment towards facilitating attempts to improve these features.  Improvement in these features can then also be interpreted as progression in the relationship.

Intimacy theory according to Cordova & Scott (2001) not only asserts that intimacy development is an interactive process of partners reinforcing one another by sharing and responding supportively vulnerable behavior and expression, but also increases personal vulnerability.  Close partners become uniquely sensitive and develop increased potential to being hurt by each other.  In intimate relationships, purposeful and accidental injuries can be frequent and emotionally challenging.  The therapist should tell clients that no one can hurt you as much as the person you love.  No one else is allowed to be as close to you, to know you as well, or to have the opportunity or more opportunities to clumsily or purposely hurt you as an intimate partner.  The therapist can emphasize these vulnerability consequences of intimacy with an example.  A husband said that "I can have a dream where my wife is cold or mean to me, and I'll wake up depressed and upset!  Even though, I know nothing really happened, I'm still a bit distressed.  Other people who are not as close and for whom I do not care as much about or have not invested so much with… I don't really care (as much) what they think about or do to me."  How often or how badly vulnerability is violated depends on each individual's makeup.  His or her responses also depend on earlier experiences.  "If one has acquired poor emotion skills, interpersonal hurt is enacted as retaliation, withdrawal, defensiveness, hostility, or avoidance, diminishing intimacy and overall relationship health.  On the other hand, if one has acquired adequate emotion skills, interpersonal hurt is enacted as self–disclosure, confident emotional communication, repair seeking, positive approach, appropriate self–care, forgiveness, relationship–enhancing attributions, and assertive communication, maintaining intimacy and enhancing relationship health. Additionally, partners with adequate emotion skills are likely to hurt their intimate partners less frequently, further facilitating the development and maintenance of intimacy. (page 985)" Mirgain & Cordova (2007)

Individuals' emotional skills, therefore affect the relationship.  The emotional skill level of the partners affects trust and vulnerability, which are highly linked and essential to intimacy.  Trust allows for an individual to make personal disclosures or engage in behaviors that expose one or more vulnerabilities.  An exposed vulnerability puts the individual at risk, hopefully with someone who will honor the trust.  Hopefully, that someone has the emotional skills to honor the vulnerability and trust.  The therapist can introduce the concepts of how vulnerability builds trust and the intimate relationship.  Offering vulnerability, trust, and intimacy creates a sanction- an expectation of reciprocality by the other person.  A message has been sent, there is an anticipated experience by the recipient, and a response… specifically, and a response in kind is expected.  Hunter (1980) states that, "According to… social reward hypothesis, the receiver of a self-disclosure sees the intimacy level of the disclosure as an indication of the sender's trust and liking.  To the extent that this disclosure has been of an intimate nature, the receiver feels socially rewarded and, as a consequence, likes the sender" (page 409).  Self-disclosure can trigger a reciprocal process.  "When the receiver of a self-disclosure becomes a sender, his disclosure behavior is more intimate if he received an intimate disclosure than if he received a nonintimate one... senders of a self-disclosure might use the intimacy level of their own disclosure to infer their own trust and liking for the receiver (cf. Bem, 1972).  Bem maintains that self observers rely on the same cues as outside observers.  Just as a receiver might look at the level of a self-disclosure in order to ascertain how much the sender likes and trusts him, the sender might look at this same disclosure to answer the same question.  Thus, each act of disclosure would be affecting the sender's liking for the receiver in a parallel position to the receiver's liking for the sender" (page 410).  Principles for building the therapist-client rapport or relationship are highly analogous to intimacy between partners, family members, and close friends.

The therapist can explain to the individual, couple, or family in the following fashion, "Let me explain using how you and I would develop trust to explain how two people deepen a relationship.  "If I show my vulnerabilities to you… if I open my heart and reveal my anxieties, fears, hopes, joys, needs, dreams, injuries, and traumas to you, I honor you.  I honor you by revealing my vulnerabilities, implicitly saying I think and have hope that you are a kind, sensitive, and caring person who will honor my vulnerabilities… that you will hold them gently and respond with respect and care.  If I don't show my vulnerabilities to you… if I hide my heart and feelings, I dishonor you.  I dishonor you by hiding myself, implicitly saying I think that you are unkind, insensitive, and uncaring unworthy of sharing my vulnerabilities with.  Then there are two types of responses from you.  First, if you hold my vulnerabilities with sensitivity and caring… great! You show me that you are a kind person and worthy of my taking a risk in investing a bit of trust in you.  On the other hand, if you abuse my vulnerabilities… if you doubt, question, or insult my anxieties, fears, hopes, joys, needs, dreams, injuries, and traumas, you dishonor me… you betray my hope that you are a kind, sensitive, and caring person.  The beginnings of mistrust color my sense of you."

This is only the beginning of the process however.  The first person has risked trusting the other person, and if he or she came through, all is going well.  If the other person did not come through, mistrust has begun to build. If the response was positive, sharing vulnerability appears to work to build trust, intimacy, and the relationship.  However, does it… will it work the other direction?  Will it be reciprocated?  This may be between the therapist and an individual, or between two partners, two family members, two friends, or two work or school colleagues and further among various members of a family or other social constellation or group.  The therapist continues, "And, now it's your turn. If you show your vulnerabilities to the other person, to me for example… if you open your heart and reveal your anxieties, fears, hopes, joys, needs, dreams, injuries, and traumas to me as well, you honor me.  You honor me and further confirm my (or the other person) first risking revealing vulnerabilities.  Your sharing shows that you return the trust.  You hold me as a kind, sensitive, and caring person that you are willing to trust with your vulnerabilities.  You have reciprocated my investment and trust in you.  However, if you don't show your vulnerabilities to me… if you hide your emotions, you disappoint and betray me.  Your withholding makes me feel you think I am unworthy, unkind, insensitive, and uncaring.  The relationship becomes unequal with my sharing and you keeping secrets."  For some individuals, this little therapeutic speech about revealing and honoring vulnerability is consistent with his or her relational value system and practice.  On the other hand, for others it may be alien because of cultural models and/or family dynamics.  There may be a mismatch between the members of the couple or between a client and the therapist.  If this mismatch is unarticulated and implicit expectations are assumed to be binding, then the relationships can become strained.  The unfamiliar communication may be subject to problematic speculation.

Gore, et al (2006) discusses the consequences of potential mismatch in relational styles.  "What are the negative consequences of having a highly relational self-construal?  One may suspect that highly relational people present an intimate side of themselves too early in the relationship, making the recipient either uncomfortable (I don't want to make myself vulnerable to someone I don't know) or suspicious (This person wants me to feel sorry for them so they can get something in return).  However, the recipient's response depends on whether he or she perceives the discloser as a friend or as a stranger (Derlega, Winstead, Wong, & Greenspan, 1987; Town & Harvey, 1981; Wortman, Adesman, Herman, & Greenberg, 1976).  Disclosed information from a stranger is often attributed to the discloser (That person must tell his personal story to everyone), whereas disclosed information from a friend is viewed as a sign of trust (He sees me as a person that he can trust).  Thus, attributions of disclosed information by a friend typically result in reciprocated disclosure from the recipient (Derlega et al., 1987), which is evident in these findings.  If highly relational people were disclosing too early in the relationship, the recipient would avoid reciprocated disclosure.  Instead, we found that the recipients responded by disclosing intimate information back to the highly relational individual" (page 99).  This finding suggests that disclosure (or the expression of vulnerability) tends to prompt reciprocal disclosure even if the recipient is not normally disposed to reveal him or herself.

The therapist or individual who uses self-disclosure with another may be "priming the pump" to get the other person to "flow."  However, an individual may be able to step up and respond to the needs of another person, but may not be able to show vulnerability to another.  Being sensitive, kind, nurturing, helping, or supporting another person can keep one person (partner, family member, friend, colleague, or therapist) in a superior hierarchal position.  The "helper" stays in a dominant position to the subordinate position of the "helped."  Some men who have been raised to be the "big dog" or the alpha male can readily assume the role of the gallant knight able to save a damsel in distress or to slay a fierce dragon.  However, a person may sense being in need or revealing vulnerability becomes tantamount to becoming the damsel in distress- an unacceptable role for many individuals.  Other family or cultural patterns vary on the acceptability of exposing ones vulnerability.  These patterns or models can become problematic when carried into the couple or other relationship that is supposed to be intimate.  The second person needs to not only respond to the first individual's vulnerability but also to expose his or her own vulnerability.  This becomes an implicit golden rule of the intimate couples relationship- to expose oneself or else one insults the partner as being unworthy of holding ones vulnerabilities.  An unaware or unsophisticated therapist may feel disrespected if the client is unable or unwilling to reveal him or herself.  And, may pathologize the reaction as client resistance rather than indicative of important values and behaviors.  

Given the opportunity to respond to the second person's vulnerability,  "If I treat your vulnerabilities with sensitivity and caring, I confirm to you that I am a kind person and worthy of your trust… worthy of risking intimacy.  If I abuse your vulnerabilities… if I doubt, question, or insult your anxieties, fears, hopes, joys, needs, dreams, injuries, and traumas, I dishonor you… I betray your hope that I am a kind, sensitive, and caring person.  The beginnings of mistrust will color your sense of me."  Mistreatment, which consists of failing to hold vulnerabilities with kindness, will break down the relationship.  Mistrust or trust grows as the process cycles repeatedly.  If both individuals respond well and honor each other's vulnerabilities, trust and an intimate relationship grow a little bit with each interaction.  The growth prompts the partners, family members, colleagues, and therapist and client to risk further vulnerability with each other.  As further vulnerability is honored and reciprocated, gradually greater trust and a more intimate relationship grow.  Over and over, continued positive consistent interactions build a stable healthy couple, family, social group, or therapeutic relationship.  If one or both persons respond poorly to each other's vulnerabilities or withhold vulnerability, then mistrust grows and intimacy fades.  In couple therapy, the couple often has suffered inadequate interactions around sharing vulnerability.  The therapist can bring this to a conscious level for discussion, examination, and adaptation.

Bader (2010) identifies as challenging the therapist managing revealing negative aspects of oneself when vulnerable.  "The next part is tricky.  Ask them to tell you the emotion that is hardest for them to show to their partner when they're at their worst.  When they're at their worst the way that they act is covering a more vulnerable feeling and in this particular case one client said, 'When I puff up and get grandiose I'm covering up fear.'  We worked to get to that.  'When I break possessions I tend to be hiding the fact that I feel a lot of shame.  When I scream and escalate it's usually covering up the fact that I feel inadequate and helpless.  When I yell, I don't want my partner to see that I'm feeling very vulnerable or fearful'... Ask them to tell you the emotion that is hardest for them to show to their partner when they're at their worst.  When they're at their worst the way that they act is covering a more vulnerable feeling… what they want to do instead of these things.  When they're at their worst, what do they want to shift that will make a definite change in the relationship?  And here what that client said was, 'What I want to do instead is I want to say that I'm frightened, be able to admit that I did something that may have been stupid and unthinking, and know that that's just human.  I also want to be able to take deep breaths and be able to take a timeout.'  And the last one was, 'I want to be able to say 'I don't know how to help you now,' to my wife.'"

The therapist needs to evoke from an individual his or her fears of being harmed by another, being unappreciated, or being inadequate in meeting the other's needs.  The partners in a couple however may not openly introduce experiences of being hurt, being unappreciated, or being inadequate, which are key vulnerabilities for partners in a couple.  Nor may an individual client always reveal him or herself to the therapist for a number of different emotional, psychological, cultural, or other reasons, including when the individual has been mandated or coerced into therapy.  The individual or one or more members of the couple or family may start therapy with recriminations and accusations against another person present or outside of therapy.  The common "trick" of couple or family therapy is how to get enough information about the dynamics of the relationship without letting the couple or family repeat the negative dynamics in therapy.  Repetition of negative relational dynamics in individual therapy with the therapist may be a part of therapeutic strategy, but elimination or reduction of such dynamics in session is often a transitional goal to elimination or reduction in life processes.  The therapist should not focus on the fact or fiction of the behaviors but instead focus on and focus the individual, partners, or members on the feelings of harm, lack of appreciation, and inadequacy.  These are all forms of injury or harm.  The accused person if present in therapy will often want to argue the accuracy of the transgression.  Often, therapy gets waylaid into the minutia of details and specifics.

Not at 3pm- it was at 3:15pm…

No, it was only 3pm or at most, 3:05pm...

No, the show had already started and it starts at 3pm…

That show doesn't always start on time…

Yes, it does!

No, it doesn't!

You hardly ever watch that show anyway...

Yes, I do!

No, you don't!"

It's surprising that that the therapist doesn't just shout at the couple or family, "Stop it!  I don't care what time it was!  It doesn't matter what time it was!  Stop it!"  In the process of arguing irrelevant minutia, the core feeling from the core point is often lost.  In many cases, the core point is something like, "I expected you at a certain time and I waited for you."  And most importantly, the core feeling is "I felt alone and abandoned by you."  Drawn into the argument, the aggrieved person or who more critically is the emotionally injured person does not have his or her grievance, much less hurt placed on the therapy table.  The aggrieved person has attempted to reveal his or her vulnerability by naming an interaction where he or she was hurt.  Unfortunately, poor communication habits often result in the emphasis being placed on the hurt or vulnerability.  Instead, the aggrieved person emphasizes the negative behavior or labels the other person's intent as purposefully hurtful.  The other person in session or outside in some home, work, academic, or social situation is first often readily drawn to argue the degree of negativity or the specificity of the accusation.  Secondly, but often bypassed, he or she attempts dispute that he or she had negative intentions.  Far too frequently, acknowledging much less attempting to soothe the aggrieved person's injured feelings is completely lost in the swirling arguments.  This highly problematic dynamic may be purposefully or instinctively prompted by an individual to avoid the accusation or possibly the shame of having failed the aggrieved other person.  Ironically, the aggrieved person's expression of vulnerability often triggers intense vulnerability in the criticized other person, especially an intimate partner.  The criticized person may become worried or terrified that he or she has messed up, or that any response may be inadequate for the aggrieved person.  The criticized person's defensive mechanisms may manifest to frustrate the aggrieved person instead of affirmative or validating reactions that are soothing.   Underlying both individuals' anger, anxiety, and hurt may be betrayal especially in romantic relationships.  The therapist can bring up the concept of betrayal even if or especially when an individual has not or neither partner in couple therapy or no member in family therapy has brought it up.  

In individual therapy, the therapist both validates the person's feelings and challenges his or her interpretation of the actions and motivations of the other individual not present in therapy.  On the other hand, Wile says, "One of the advantages of couple therapy is you can move in and speak for the partner... For example, if I'm reacting to how one partner seems to be bullying the other, I can move over and, speaking for that person, I can say, 'When you get bullying like this, I just stop listening and wonder why I'm in this relationship.'  The partner I'm speaking for usually likes this, and I feel much better—so much so, in fact, that I'm suddenly able to look at things from the point of view of the bullying partner.  My feeling of empathy has returned for that person and I move over and make a confiding statement for him. (Wetherford, 2010)."  The therapist can verbalize that partners hold each other to a powerful but implicit contract of sensitivity, attention, compassion, and appropriate response.  This is one of the "golden rules" of couplehood.  More or less, the rule is "If one loves and respects the other, then he or she will be automatically sensitive to any vulnerability the other partner experiences.  He or she is expected to be naturally and intuitively attentive to any vulnerability without the other partner drawing his or her attention to them.  He or she then is to immediately have compassion for any vulnerability the other experiences.  And of course, he or she is to respond with the appropriate communication and/or behavior without any guidance."  Why wouldn't a partner tell the other that something is bothering him or her and what he or she needs from the other?  The implicit addendum to the prior golden rule is, "Because it doesn't count if I have to tell him (or her)!"  These golden rules of couple relationship are normally not expressed, but often rigorously enforced.  Since the first rule is in the form of an "If… then…" structure, the complementary rule becomes "If not… then not…"  The failure of the criticized person, especially a partner to respond appropriately as desired by the aggrieved person/partner results in the conclusion that criticized person does not love or respect the aggrieved person.  As a result, the partner who is disappointed feels fundamentally betrayed in couple's contract.  Often the avoidant or defensive reaction of the criticized partner becomes tantamount to a second betrayal.  After failing in the first round, even with the vulnerability having been expressed openly or directly (violating the "telling" part of the golden rule addendum), the avoidant or defensive response further betrays the aggrieved partner.  

In many difficult couples or problematic relationships, often neither person is able to identify much less verbalize his or her vulnerabilities.  Or, when feeling vulnerable, are they unable to refrain from avoidant, defensive, and eventually aggressive or passive-aggressive communication and behaviors.  Yet, both will still hold each other implicitly responsible to adhere to some "golden rule" of sensitivity, attention, compassion, and appropriate response to vulnerability.  The more overtly intimate the relationship such as a romantic couple or a family, the stricter is the golden rule.  However, such rules also exist to some degree in casual, work, or other social or institutional relationships.  In all cases, to some degree failure becomes betrayal.  Underlying betrayal is the expectation of trust and investment in each other to enter into the couples contract (or work, mentor-mentee, teacher-student, government-citizen, and other contracts).  Trust and investment comes from caring about the other person.  When vulnerability is betrayed and the relationship falls into swirling anger, caring is often forgotten.  By the time many couples present for therapy, one or both partners may be afraid to care or be vulnerable.  Or, a family is deeply and painfully dysfunctional.  Or, an individual has a long trail of relationship wreckages and devastated self-esteem.  Repeated cycles of dysfunctional communication will be duplicated in therapy between partners or among members (or with the therapist) unless the therapist intervenes.

The aggrieved person's complaints and accusations can be interpreted to reveal the underlying emotions and needs.  Since the person may be unable to reveal his or her vulnerability- for example, say "It hurts that you don't (he or she doesn't) spend time with me," the therapist may say, "That sounds like you felt alone and abandoned."  Often this type of interpretation will shift the person from anger to sadness or hurt.  The therapist can follow up with various strategies depending on his or her therapeutic orientation and style.  The therapist can also interrupt avoidant or defensive responses by the criticized partner or family member (if present in couple or family therapy) with, "Do you… did you mean to hurt him/her?"  In individual therapy, the prompt may be "I wonder if he or she was trying to hurt you or maybe instead being clumsy."  This shifts the attention from arguing the minutia of supposedly absolute reality of what happened to the implicit accusation that is so sensational.  The other person may respond, "Of course not.  I didn't want to hurt him/her" or the individual may consider, "Maybe he she wasn't trying to hurt me."  Being accused (however tangentially) of purposely trying to hurt a person and in particular, ones partner is impugns ones integrity.  Another potential implicit intimate relationship rule is that each person/partner is supposed to know each other well enough to know that the other person/partner would not do anything that might be hurtful.  If he or she does, it is interpreted as being purposely hurtful.  This approach can bring such implicit rules to the surface so an individual, both partners, or family members can examine, re-affirm, or adjust them with the therapist's assistance.  Once re-affirmed or adjusted, the individual, partners, or family members can then discuss which communications and behaviors were experienced as betrayals of these rules.  This brings intent and motivation to the therapy table instead of the individuals just identifying, much less repeating lousy techniques and disastrous consequences.  

The therapist should focus the individual, partners, or family members on the emotional injuries that have been caused by the communication and behavior, rather than allowing therapy to degenerate to the individual or each partner or family making accusations or assigning blame to others present or outside of therapy.  Revealing harm suffered exposes ones vulnerability and gives the other person a chance to be compassionate and caring. The therapist may choose initially to model compassion rather than immediately prompt the other person's response. "If you thought your partner (this person) didn't care, that would really hurt," or "It must be scary to think your partner (this person) wanted to hurt you" pointedly emphasizes the vulnerability.  The therapist can also interject to the other person if present in couple or family therapy, "Trying to hurt your partner (or family member)… not caring… that doesn't sound like the partner (or family member) you want to be."  The specific therapist communication will depend on the therapist's style and orientation and his or her sense of the energy and direction of the therapy.  However, the therapist should encourage, if not require any client and especially, partners in a couple that they must commit to risk vulnerability and trust.  The therapist should acknowledge the difficulty- specifically the extreme discomfort involved in risking vulnerability.  Therapy may require acknowledging and exploring that the difficulty in risking vulnerability may be personally or culturally based.  Personal discomfort with risking vulnerability may come from harmful family of origin experiences.  Cultural discomfort may be gender-based for some men or come from other cultural relationship and communal rules.  In addition, there may be discomfort in experiencing the vulnerability of ones partner, family member, colleague, or other person from similar or comparable cultural or family dynamics.  The approach just discussed may or may not be applicable or successful to a particular individual, couple, or family.  However, the therapist must find a way to first get an individual, partners, or family members to risk vulnerability and second, to honor each other or another's vulnerability.

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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