8. Using the Five Foundations - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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8. Using the Five Foundations

Therapist Resources > Therapy Books > DownRelRabbitHole- Assessment

Down the Relationship Rabbit Hole, Assessment and Strategy for Therapy

Any strength in any five of the foundations of relationships: trust, vulnerability, expression, empathy, and investment such strength can potentially be accentuated to build up the other areas.  In most cases, the investment led to participation in therapy (a risk in of itself), which can be used to activate greater empathy.  Whatever is and wherever is the strength is where the therapist needs to work.  The therapist needs to go in the door that is open (or slightly ajar!).  The therapist's theoretical orientation or preferred style may not gain access into the individual, couple, or family.  Adapting to what is available is the therapist's challenge.  Examining or speculating about stereotypical cultural gender distinctions may allow individuals to recognize or confirm their experiences.  Requiring the partners to articulate them may be difficult.  For example, in their study, Greeff and Malherbe (2001) made the following conclusions, which can be presented to the heterosexual couple and individuals in general for consideration:

a) There is a significant difference between men and women's experience of intimacy;

b) men are significantly less satisfied with their experience of sexual intimacy than women;

c) men are significantly less satisfied with the recreational aspects of their relationship than women;

d) there is a greater difference between women's experience of social intimacy and the degree of social intimacy they desire than in the case of men;

e) women show a greater discrepancy between their experience of sexual intimacy and the degree of sexual intimacy that they desire than men do; and

f) a significantly positive correlation exists between the experience of intimacy and marital satisfaction. (page 256)

The therapist who speculates and checks with clients as to the veracity of these stereotypes may prompt one or more or possibly, all five of the foundations for relationship.  The therapist would need to have sensitive therapeutic skills, as he or she would in exploring any stereotype or risk stereotyping clients.  Culturally or from family-of-origin training, strength and availability in certain areas and not in others may be revealed, however when investigation is well done.  The therapist usually cannot break through closed doors.  He or she should access the entry that is the most available or familiar for the individual, couple, or family. Once inside, the therapist can work on those other doors... the therapist can work on a cross-cultural translation.

Despite great fear to risk trusting again and many injuries, a member of a couple became able to risk being vulnerable (keep trying) because he knew about and understood the horrific history of sexual abuse that his wife had suffered during childhood.  Chaz loves Alyssa and is heavily invested in her, their relationship, and the family (three kids).  He understands her lashing out is not about him at its root, but from her deep shame and rage from childhood victimization.  Therapy helped facilitate continued investment despite deficiencies in other areas because he learned for the first time during sessions the extent of her abuse.  This allowed Chaz to focus less on his outrage, see past Alyssa's toxic behavior, and relate to her underlying pain.  And, to keep trying.  Cultural challenges in this situation included the stigma of shame from having suffered sexual abuse rendering Alyssa feeling herself deficient material for marriage, the keeping of secrets to deal with shame, Chaz's difficulty in being present with her pain, his sense of impotence caused by her being in pain which he could not admit, her difficulty in expressing her pain, a sanction against expressing sexual needs, and the lack of permission and forums to express the trauma.

Jay was angry at Britt for not being supportive about his career goals and challenges.  The therapist had him explain what the non-support meant to him.  Jay felt that Britt didn't understand how important it was for him to take risks and move forward.  He talked about his dreams and what they meant to him.  He was third generation Eastern European-American of entrepreneurial background.  The therapist asked Britt if she had any dreams.  The therapist was prompting and looking for any empathy.  She snapped that she didn't have any dreams.  When asked if she ever had any dreams, Britt said she wasn't sure if she had ever had any.  Asked why not, she initially had difficulty expressing herself.  However, because of earlier work about her dysfunctional childhood, the therapist already knew that being compliant and shutting down was how Britt dealt with life- a life that included an emotionally erratic and abusive father.  Sometimes, the therapist needs to "speak" for someone who is not articulate enough to do so for him/herself.   The therapist "spoke" for her.  "Having dreams would have been risking being put down… being punished for wanting.  You never were given permission to dream… too selfish and not for incapable little girls… according to your family rules."  Britt agreed that was probably right.  The therapist directed her attention to Jay, who was red-faced and had tears running down his face.  "How does it feel to know Britt couldn't have… maybe is afraid to have dreams?"  Jay responded that it was very painful for him, that dreams meant so much to him and that realizing that Britt had been deprived of this essential energy made him hurt for her.  He continued with more. With a smile, the therapist asked Britt how he did.  She laughed, "He did pretty well!"  And, she felt loved.  Afterwards, they were able to talk more about sharing dreams.  Cultural challenges in this situation included the evoking and examining family patterns regarding dreams, understanding the impact of child abuse upon risk taking, and understanding the impact of supportive parenting upon risk taking.

Sometimes, the therapist can be very overt with clients about risking trust, vulnerability, and investing.  "Take a chance.  Risk telling the other person- your partner how you hurt." "Your homework is to take a chance trusting him/her by…"  Some clients will follow through.  Whether the interactions are immediately successful or not, they create movement in the relationship.  The therapist should always acknowledge how difficult it is to take these risks.  Many persons in painfully involved relationships reduce the pain by minimizing interactions.  Unfortunately, this also reduces any possibility of communication improving.   A paradoxical intervention here may be useful.  The therapist can predict the failure of the risk taking, and instruct the clients to observe their inner feelings and process to learn about what breaks their process down.  This makes "failure" a learning process—a positive opportunity.  Kira was instructed to talk about the fight from the holidays at her family's house—an incident Kira and Kelly had been avoiding discussing because it was so heated and painful.  They were told to go ahead and get mad, but to be sure they told each other either during the fight or afterwards what was hurting that was under the anger.  Even if they could not do that at home, it could be processed in therapy.  The therapist's overtly stated confidence in the process—that each of them could handle the couple's poor process and move it towards more positive resolution may be what gives the couple the confidence to take risks, be vulnerable, and invest.  The cultural challenges this situation included individuals being stuck in an established cultural pattern of behaviors.  The therapist may find it beneficial to teach these foundations early in therapy, particularly when relationships are the major issues for an individual and in couple and family therapy as a means to gain an assessment of the quality of the relationship between the individual and the object of his or her distress, between the partners in a couple, and among family members.  The assessment leads to the therapeutic strategies to facilitate the five foundations with the individual, couple, and family.

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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