246: PACT Informed Couples Therapy with Michelle Garraway

Welcome back to The Couples Therapist Couch! This podcast is about the practice of Couples Therapy. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

In this episode, Shane talks with Michelle Garraway about PACT Informed Couples Therapy. Listen to the episode on Apple Podcasts, Spotify, and your other favorite podcast spots, and watch it on YouTube – follow and leave a 5-star review.

• Episode Summary & Player
• Show Notes
• The Couples Therapist Couch Summary
• Transcript

The Couples Therapist Couch 246: PACT Informed Couples Therapy with Michelle Garraway

This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more

Get the Couples Therapy 101 course: https://www.couplestherapistcouch.com/

Join the Couples Therapist Inner Circle: https://www.couplestherapistcouch.com/inner-circle-new 

Join The Couples Therapist Couch Facebook Group: https://www.facebook.com/groups/295562197518469/

In this episode, Shane talks with Michelle Garraway about PACT Informed Couples Therapy. Michelle is the Founder & Clinical Director of The Relationship Agency, where she specializes in PACT (Psychobiological Approach to Couples Therapy). Hear what makes the PACT model fun & different, how the PACT process works with couples, what you can learn when couples face towards each other, some of the most common PACT exercises, and when it’s time to have your clients focus on soothing Here’s a small sample of what you will hear in this episode:

• What is each individual's role in the dynamic?
• The role of responsibility and accountability in the PACT system?
• What is the PACT model?
• Shared principles of the relationship
• Using cross questions to train partners to be more attentive

 

To learn more about Michelle Garraway, The Relationship Agency, and The PACT Institute, visit:

TheRelationshipAgency.com

Instagram @Relationships.Are.Everything

ThePACTInstitute.com

 

 Check out the episode, show notes, and transcript below:

 

Show Notes

• 246: PACT Informed Couples Therapy with Michelle Garraway

• This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more
• [1:22] Welcome to the show, Michelle Garraway!
• [5:29] Why is Michelle drawn to the PACT model?
• [8:10] What are the principles of PACT model?
• [10:36] How does Michelle know which area or principle to prioritize?
• [12:10] How structured is the process?
• [14:49] Do they answer these questions ahead of time or in the session?
• [15:41] What is the PACT differentiator?
• [17:05] What is your role in the dynamic?
• [20:36] Shared principles of the relationship
• [22:56] How to interact with one person blaming their partner?
• [26:19] This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more
• [27:10] Seeding curiosity in the couple
• [29:03] How does Michelle relate the past to the present issues the couple is addressing?
• [31:00] What's the difference between create safety for themselves rather than leaning solely on the partner?
• [34:08] When to focus on soothing?
• [36:47] The best time to set up the relationship agreements and plans
• [38:12] If you don't know what you need, it'll be hard to advocate for yourself when dysregulated
• [40:02] The therapist is the master regulator
• [45:45] Michelle's final thoughts
• [46:02] Check out the PACT institute
• [46:45] Connect with Michelle Garraway and The Relationship Agency
• [39:36] This episode is brought to you by Alma. Visit HelloAlma.com/ATPP to learn more

 

What is The Couples Therapist Couch?

This podcast is about the practice of Couples Therapy. Many of the episodes are interviews with leaders in the field of Relationships. The show is meant to help Therapists and Coaches learn how to help people to deepen their connection, but in the process it explores what is most needed for each of us to love, heal, and grow. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

Learn more about the Couples Therapy 101 course: https://www.couplestherapistcouch.com/

Find out more about the Couples Therapist Inner Circle: https://www.couplestherapistcouch.com/inner-circle-new

Transcript

Note: this transcript is not 100% accurate.

00:00

So we say as soon as you  learn what it looks like when your partner gets outside of their window of tolerance or is kind of nearing that, your job is to drop it and move to soothing.

 

00:13

to The Couples Therapist Couch, the podcast for couples therapists, marriage counselors, and relationship coaches to explore the practice of couples therapy. And now,  your host,  Shane Birkel.

 

00:29

Hey everybody. Welcome back to The Couples Therapist Couch. This is Shane Birkel, and this is the podcast that's all about the practice of couples therapy.  Thank you so much for tuning in. I'm a licensed marriage and family therapist, and the goal of this podcast is to help you learn how to more effectively work with couples and possibly even learn how to have a better relationship. The episode this week is brought to you by Alma. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates.

 

00:58

Alma handles all of the paperwork and guarantees payment within two weeks. Visit HelloAlma.com/ATPP or click on the link in the show notes to learn more. Hey everyone, welcome back to the couple's therapist couch. This is Shane Birkel and today I'm speaking with Michelle Garraway, PACT therapist and owner of The Relationship Agency. Hey Michelle, welcome to the show. Hi Shane, good morning. Thanks for having me.

 

01:23

Yeah, thank you so much for coming on. I should clarify, PACT  is psycho... Psychobiological approach to couples therapy. Psychobiological, which is one word, psycho-biological approach to couples therapy. So I'm excited to talk more about that, but why don't you tell everyone a little bit more about yourself? Sure. So as you shared, I'm level two PACT therapist. I work with couples.

 

01:48

I'm a registered social worker. have a master's in social work and my undergrad is a double major in psychology and criminology.  And I'm also the CEO founder of the relationship agency.  It's a therapy clinic. I'm based in Oshawa, Ontario, Canada, just outside of Toronto. Me plus a team of six therapists working together. We see people in person online and we are all social workers. Even my admin, Candice, who's amazing. She's a BSW and everyone else is an MSW. Great.  How long have you been doing PACT for?

 

02:18

I don't even remember.  I think three years. I actually am a little  atypical in terms of being a therapist and owning the clinic. I spent  a little more than a decade in the public sector. So I started out as a lot of social workers do, doing work in halfway houses, crisis lines, things like that. And then a good chunk of my experience was in the public sector in  what we call poverty work. So our welfare program here is called Ontario Works. I started in the front lines and worked my way up.

 

02:46

I'm doing air quotes, into roles in policy research innovation. By the time I left, I was the manager of strategy and organizational performance. it really,  it was, signs were early on that it wasn't really the best fit for me.  I'm  generally unmanageable. So working in a  highly regulated area wasn't the best fit for me. I learned a ton, but by the time I left, I was further away from kind of working with people, which is what my passion is. And then came into PACT.

 

03:15

actually quite an interesting story.  When I was doing my practicum, my supervisor's mother is a PAC therapist. She's been involved with PAC for a very long time and she introduced it to me and I had always kind of shied away from  clinical work a little bit because I only understood it as pathology. That's the lens I looked at it through. So that was not exciting or fun to me. But once I learned about PAC and had a real understanding of attachment and learned that there's a different way you can do things, I was all in.

 

03:44

short way of saying three years  and the relationship agency has been around for two years and here I am. Yeah, I mean I think here in the states as well a lot of times we'll use this phrase like agency setting, know, there's a lot of agency settings that you know can be  they're incredibly helpful and I'm glad that we have that available for people but there's a lot of oftentimes like bureaucratic stuff that comes into it that makes it harder to do

 

04:11

to actually just work with the people and feel like you're helping the people themselves. And there's a lot of  management and there's a lot of  things like that. So I think a lot of people have a similar experience where they end up at some point feeling like it's not a great fit for the longterm and sort of wanting to  step out.  And  I think there's a lot of freedom in being able to choose what kind of trainings you want to do at that point and how you want to work with people and whether you want to...

 

04:40

specialized with working with couples and things like that. Yeah, yeah, it definitely poured a lot into me and I learned a lot from it.  But it wasn't the end game. And I think that's what you shared is also reflected in the therapists who work for me.  The therapists who work for me I've learned after hiring and ending contracts with people, the ones who stick and who really fit are the ones who  do  currently work in hospitals or MBA or those settings or have a four and they just can't take it anymore. So they show up to me and say, I can't do this.

 

05:07

They want to do therapy in a really meaningful way and show up as themselves and  be authentic and be ethical. It's the common trajectory for a lot of us and I'm glad they ended up here and that I ended up here too. Yeah, that's great. So talk a little bit about what resonates for you with the PACT model and what made you feel like that kind of inspired you to want to work with people in that way. Sure. Oh my gosh. Okay. That's a big question. So I think that the easiest way to share it is that the PACT model

 

05:37

is so clear,  it's it's poly theoretical. So it's founded on so many things that are so important in understanding how we function as humans and how we function in relationships. And then it gives you really clear language and frameworks for what a healthy relationship should look like. So in PACT, we talk about secure functioning and it's based on safety, sensitivity, justice, collaboration and mutuality. So right there, when I meet with couples in the beginning, I can say,  this is what we want your relationship to look like.

 

06:06

My job is going to be to push you towards that, knowing that that's a standard and you're going to fall short. And then within that, we're also going to work on when you do fall short, how are you going to treat each other? So it really started with changing how I see relationships and how I understand relationships. Giving me a framework, giving me language for the things that I was experiencing, the things I was bumping up against, and then actually seeing it in action. That's one of the things I think I mentioned when I reached out, why I like practice. It's so enjoyable to practice.

 

06:35

Like you're very, it's tiring to practice because you need a lot of presence. talk about being the master regulator in the room, but it's also fun.  know, Stan says you should, you should never be bored when you're practicing,  um, should be engaged. We move on inspiration.  We move our bodies. We're testing things out constantly. So just the way of doing it. And it's also, it's very strategic and it also requires, um, a very, very curious investigative mind, which really kind of tickles my brain.

 

07:04

and makes it fun. Yeah, definitely. And I think that's  characteristic  of a lot of good couples therapy,  you know, which might feel different than individual therapy at times where, you know,  we aren't,  I don't think good couples therapy can just be the, you know, a therapist being a good listener and validating both people's perspectives.  Because  I think  people need a lot more of the strategic approach  and

 

07:35

you know,  being more interactive with what's going on in the couple. Yeah. And you're right about what people need, because one of the understandings we have in PACT is that people  often and usually until they're aware of it act against their own best interests.  People will tend to turn adversarial if things get  tricky, which they often do when you're in relationship. So we have to be strategic and be pushing people towards certain areas or  setups or situations based on what our

 

08:05

my hypothesis about what's going on here. So can you list out those things again, like the safety, you know, of those things that are required for Yeah, the principles of secure functioning. So safety at its base is physical safety, but also knowing that with you, you're not going to intentionally hurt me. Of course, I'll get hurt in relationship because that just happens, but I know that I feel safe. You're not a threat to me. You're not my enemy. You're not a harm.

 

08:31

Sensitivity has to do with an awareness of what's going on with your partner. So kind of on two levels. So  on just like what's going on in your life, how's work, how's your relationships, what's bothering you, what's going on.  But really, I think one of the differentiators with PACT is a sensitivity to your partner's arousal states  and their affect and you know, what does it mean? I'm sensitive to, I know if Shane really furrows his brow, I can tell you exactly what that movement makes. So we do a lot of...

 

08:59

We're paying attention to micro expressions and micro changes and teaching people also to pay attention to the micro changes in their partner. So in a sensitivity to, if I say this thing and I notice the shift of my partner, I know what it means. So we talk about having your partner's operator's manual, fully knowing what it is. So then I can make choices based on knowing who you are. have a sensitivity to you, who you are.  Justice is about equal sharing of power in the relationship. And it's also about quick repair of harm.

 

09:27

That's one of the focuses of PACT that we really push people to be fast and tidy  at repairing when they do have ruptures and we do have conflict because we don't want that to lay in. We don't want you to get stuck in this state where you're adversarial and you're in conflict so that you're building that memory  in your nervous system so we move quickly. Collaboration, what it sounds like we're working together on things, we're a team.  This speaks to one of the concepts in PACT around the two-person psychological system.

 

09:54

which I was just speaking with one of my therapists this morning about,  in therapy, there tends to always be this moment where couples surrender to each other. And then we start making progress. And that's them really giving into that two-person psychological system. It's a really different way of operating. Also, you may have heard Stan call it the couple bubble. That's what we're talking about there. And then mutuality. What's good for me is good for you. And then what people don't think about, what's not good for you is not good for me.

 

10:24

So it's even a even deeper way of operating within this two person psychological system where you put your your partner in your relationship first above all else.  So tell me a little bit about, know, when you're starting off with a couple, you know, are you  beginning to identify some of these principles  or where there might  it might be the most helpful to sort of reinforce  the you know, whether it's the safety part of the relationship or the sensitivity or the

 

10:54

collaboration or something like that?  Yeah, absolutely. So in the intake, we're assessing for that.  One of the easiest ways to do that is when I say, okay, great. So the way I say it at least is I'd love to learn about your relationship from the very beginning. Take me through. And then we're looking for whether or not they have a collaborative narrative. So if one person is doing all of the talking, the other person is, if they're correcting each other or arguing about it, or if they kind of weave a tail together, is telling me if they're collaborative, right? If there's a justice, if there's a sharing of power.

 

11:23

How are they doing these things? If they tell a part of the story and the other person gets their backup, are they sensitive to that? Do they have an awareness about that?  So absolutely in the beginning, I'm looking through and seeing how they operate. And PACT is very much a, what does Stan say, a show me therapy. So I'm basing it on what's happening right in front of me. So I'm looking at content and process when I'm doing that assessment. Of course, it's all at the end of the day about process, but I'm looking to the story.

 

11:50

This is where it speaks to the therapist being the master regulator and really showing up. I'm looking, I'm listening, I'm feeling, I'm doing all of these things as I'm just having the first conversation with you. Yeah, I think that's so important, you know, because I mean, mean, the things that people tell us  are also important, but I think there's like different types of information we can gather right from the beginning. And I think what's actually happening in the room is sometimes  some of the most valuable information we can take in. Yeah.

 

12:18

How structured is the process from there? Are there specific ways that you move into the work with them or  is it pretty flexible as far as depending on what  you see with the couple? Definitely flexible.  One of my concerns or curiosities because PACT is so  academic, it's rigorous,  when you learn it, there's a lot of stuff, right? There's a lot to work with. So I was curious about,  well, can I actually just be me?

 

12:48

And absolutely you can. When I really was like, okay, I'm drinking the Kool-Aid is when Stan said, well, good therapy, you should be like a jazz player. Like I should be improvising. I should be playing with the notes that are there. So there's freedom to move. Of course, I'm going to make informed decisions based on what I'm seeing in front of me, what I know from the model, what I know as far as interventions are. But I tend to do the intake. I'll usually do what we call the PAI. So it's the partner attachment inventory. It's an adaptation of the AAI, the adult attachment inventory.

 

13:18

Really powerful because it's both an investigative tool. It's helping me to assess  attachment and make a hypothesis about what I think is going on. But it's also an intervention in and of itself.  One of the like  simple,  fundamental, but huge differences in PACT is that we have a couple sit in rolling chairs that face each other. And also because we want people to start paying attention to sensitivity and these micro changes, they have to look at each other.

 

13:44

And because we're working with neuroscience, developmental psychology, attachment, arousal and regulation, that eye contact is going to impact their state depending on a host of factors. Right.  So with the PAI,  I'll give you an example. It asks questions about like, you know, when you were young and you were hurt, who did you turn to? How would you describe your relationship with your mother? These types of things we know impact attachment. So I'm gathering information, but at the same time, the person is telling these things to their partner.

 

14:12

after we've gotten them into a hypnotic state and we're seeing how it lands, seeing how it changes things. People are learning new things about each other. Maybe they are, maybe they're not.  Then I tend to provide some psychoeducation too about attachment, which we know from an EFT model when people understand it's the cycle, it can really depersonalize, really help them understand  what's going on and that it's not a  character flaw  in any sense. The PAI is a tool that I use with pretty much everybody.

 

14:42

And then from there, it's what's in front of me.  You go with what's in the room.  do you have them fill that out ahead of time or are they answering those questions with you during the session? Yeah, they answer the questions in the session. So if we do it fully the way that Stan intended, it'll take about three hours  and they're looking at each other. We spend time getting into the kind of this hypnotic state so that they're not aroused in any particular direction, either up or down. And we slowly group. And then I'm paying attention to

 

15:12

the content,  but I'm also paying attention to the way they tell it.  If there's information missing, if I get a lot of, don't know, I can't remember, or if it's  all overly positive, gives you a lot of information about, that can help you formulate your hypothesis about what's going on with attachment. Yeah. And one of the things that  you had written in an email was about accountability in couples therapy and relationships  and

 

15:40

the pack differentiator, tell me more about that. I think  on a number of levels, the fact that we have this definition of secure functioning and that we set out from the outset, this is what secure functioning looks like, this is what I'm going to be pushing you towards. When I'm seeing people operating in a way that is not secure functioning, it's up to you to make a different choice and to show up in a different way.  It's always going to come back to you and in a number of ways, and it can be gentle and it can be loving and sometimes it's not gentle and loving.

 

16:09

It's always from a place of love, but there's always the expectation that, okay, now that you have this information, what are you going to do with it? And there's always an expectation that where there's one, there's the other. So meaning if you come in saying my partner  XYZ, well, it's likely that you XYZ also. So we're going to do some surfacing in that. And then your job is to be responsible for your side of the street.  So like you said,  exactly as you named that, you you can't really make change if I'm just

 

16:39

a forever empathetic year, the change comes in that accountability. So make a different choice. We're right here right now. What are you going to do? At any moment, either of you can do something differently. Yeah. And I think that it's much more authentic and helpful if each person is taking responsibility for themselves, right? Because a lot of times couples will come in and they'll say something like, well, we always yell at each other or we aren't being respectful with each other. We need to be more respectful with each other.

 

17:09

And it feels kind of  hard to sink your teeth into  when it's a we statement like that in those cases, because it's like, well, how is your partner not being respectful for you? How are you not feeling respected by your partner?  And how are you not being respectful to your partner? Like, those could be very different conversations that we're having at that moment. Or maybe your partner doesn't even feel disrespected or like, that's not a thing for them.

 

17:37

but it is for you. That's an important distinction to make.  I feel like  what you're talking about is helping each partner take more responsibility for themselves, trying to step outside of, what does my partner need to do to change to make me feel better? It's more like,  do I need to do to help the system change in the things that I can control? Yeah, exactly. The system is the right language.  I say it's always the dynamic.  If I were to get one of those complaints,

 

18:06

It would be, okay, well, what's your role in that dynamic? How are you contributing? How are you keeping this alive? How are you breathing air into this? What are you doing? Yeah. Well, tell me about them. Tell me about you. And I think another  thing,  another area where I see accountability  being the differentiator impact is that we talk a lot about agreements. So  if you  are, like you said,  in our relationship, you know, we speak disrespectfully to each other. Well, then from my perspective, the two of you have an implicit agreement.

 

18:34

that you speak disrespectfully to each other. So that's a choice that you've made. Fully comes from the understanding that we make choices to protect ourselves, right? All the empathy and understanding in the world for that. At the same time, you still made that choice. So now you're here in couples therapy and you have this new knowledge and this new experience. So you need to self-activate and make a different choice. So there's a high level of accountability. There's always the expectation that you're responsible for your choices and your actions.

 

19:01

totally understanding that they come from a place of protection. They come from so many things layered in that cause us to show up in this way.  At the same time, if you want a different relationship, you have to do it differently.  Yeah, I like the way you talked about agreements. I mean, I use that language of agreements a lot, which is sort of like people sometimes complain about things like, you know, my partner never comes up and gives me a hug when they get home from work or something like that. And it's like,

 

19:31

Well, was that ever spoken  out loud? Like, is that something that you want? Or did you ever make an agreement? I mean, are you disappointed because they're not following through on an agreement? are you just hoping that that like, or are you assuming that that's what would happen in a healthy relationship? you're sometimes people can be very blaming when the other partner is sort of clueless, like, oh my gosh, I didn't even realize that that was important to you. And I feel like bringing it to the level of consciousness and then conversation and then agreement.

 

20:01

about like, okay, you know, what are we agreeing to? And like you said, I love that. I love the way you said that if we're both just kind of like speaking to each other disrespectfully and kind of going back and forth, like there is sort of an implicit agreement. Well,  you talk to me that way so I can talk to you that way. And they're just continuing to perpetuate something that neither one of them wants. Yeah, you're exactly right. And it's putting things, a lot of therapy is offering perspective. But in these cases, I've said

 

20:30

couples specifically. Okay,  I want you to... So we have an exercise where we talk about shared principles of governance. So eventually,  after we get to a point where things are a bit more stable, we have some understanding, we've been able to do things, then I'll take people through an exercise where they create shared principles of governance.  And we call it principles on purpose, because principles are something that you don't waiver from. It's not just a rule, right? It has meaning for you.  It speaks to your values and your virtues. And it's really the two of you coming up together with how are we going to operate as a couple.

 

21:00

So some of the examples are, you know, we have each other's back in public and in private, regardless of what our relationship, regardless of circumstances, our relationship is above all else, always and forever, et cetera, et cetera. So I'll have couples  do the flip of that exercise and I'll say, okay, I want you to come up with the principles, the agreements that you have in place right now for your relationship. And it'll be like, okay, we have agreed that you can cheat as long as you say sorry, and then I'll just take you back. That's an agreement that we have.

 

21:28

We've agreed that  I will do all the childcare, all of the taking care of the home,  all of the kinship management, and you will just have to work. And that's an agreement that we have.  So  whatever the situation is that you're in now, you have both created it.  That's an agreement that you've made. It hasn't been explicit or not. And I love it because it's simple. Did you put it in that language? And it's like, oh, OK, let's just make an agreement for it. And then it solves it.

 

21:57

And then the beauty of packed minutes layered in, I'll say, okay, great. I want you to come up with an agreement, say for, um, how you're going to co-manage your relationship with your in-laws. Give you 10 minutes. Come up with an agreement. And then as they're having that agreement, want them to  come up with that agreement. I want them to have that conversation in a secure functioning way.  So I can coach them to have a conversation where they come up with an agreement. And in that conversation, they're speaking to each other with safety, sensitivity, justice, collaboration, and mutuality. So it's all.

 

22:26

layered in. So we're doing a hundred different things at once, but on the surface, it just looks like we're having a conversation about how are we going to manage our in-laws.  And how do you navigate that if you have a person who has a very hard time with the way that they're communicating ends up feeling blaming or judgmental or criticizing or, you know, that they're having a hard time with the sensitivity and collaboration? Typically, when we see like the blaming and the feeling of the blame, someone who  comes from

 

22:56

but more of an anxious attachment style is likely the one who's going to do more of the criticizing, the blaming, the protesting, right?  And someone with an avoidant attachment style, even if it's not blaming, criticizing, it can land on the ear often as blaming, criticizing, because those people have the feeling of, I'm not good enough, I'm never doing it right, oh, I got it wrong again, et cetera, et cetera, right? So some of that will come up when we're doing our earlier work around attachment. So for example, from the PAI, and I do psychoeducation along with it around

 

23:24

These are the typical things you see. And then when we're in that conversation,  that's where the sensitivity piece really comes into play because you can see if someone makes an ask and then that person who is sensitive to feeling criticized and blamed right now, may tense, may sludge, may look away.  Something is going to happen so quickly that they don't even realize  that I'm going to be able to catch and eventually their partner is going to be able to catch. So I'll do coaching around that.  We have specific ways of

 

23:54

speaking with people when we're in patch. So we'll do cross questioning, cross commenting, down the middle comments. So a cross question would be,  I ask a question to you,  but my target is actually your partner. So I'm asking the question to you to stimulate some sort of response in your partner. I've hypothesized that the question I'm gonna ask is gonna have them show up in one particular way, and I'm gonna see what that is. And I'm kind of, you see how it's so strategic, right? So I'm setting up down the line for you to then see if you notice that thing that happens.

 

24:23

in your partner.  So I can ask a question to prompt a response in the target. And then I may turn back to him and be like, Oh, did you see that? What does that mean? Do you know? Hmm. Interesting. Okay. If you don't know, maybe find out, or if you don't know, say something, let's see what happens. See what happens. Let's find it and kind of go, go along that way. There's a million different ways to do it, but that's one of the simplest basic ways to do it.  Yeah. And really staying with.

 

24:51

their felt experiences. Like I'm imagining, you can tell me if you have a better example or if maybe what I'm thinking is off.  But like one across sort of question might be something like, what's it like when you feel so criticized by your partner? In one sense, I do want to understand their feeling reality of it. In another sense,  I want to see

 

25:17

you know, how their partners, instead of giving their partner direct feedback about what I'm observing, I'm sort of just asking the other partner how it feels for them, something that I'm picking up on in the room. Yeah. Yeah. So I could totally see, I would ask the partner, what is it like when she criticizes you like that? Yeah. And then the partner's like, Oh shit. Like I didn't even realize I was criticizing or maybe they're like, yeah, I was criticizing you. Right? Like you're going to see that's going to give you the information.

 

25:43

that you need and a question like that would be great because it kind of shocks the system in a way.  Because we're working from the premise that people are again acting against their best interest and also they're putting their best foot forward, right? Pack sessions tend to be longer  because we know that people are going to show up in a particular way.  They're more fully resourced. They can make choices to make themselves look like the good guy and I'm cooperative and whatnot, but eventually we'll wear that down and see how they really show up when they're at home together.

 

26:12

So if I can kind of push some of that with those provocative questions, that'll move us along a bit quicker. Building a private practice can be challenging. Filing all of the right paperwork is time consuming and tedious. And even after you're done, it can take months to get credentialed and start seeing clients. That's why Alma makes it easy and financially rewarding to accept insurance. When you join Alma, you can get credentialed within 45 days and access enhanced reimbursement rates with major payers.

 

26:41

They also handle all of the paperwork from eligibility checks to claim submissions and guarantee payment within two weeks of each appointment. Plus, when you join Alma, you'll get access to time-saving tools for intakes, scheduling, treatment plans, progress notes, and more in their included platform. Alma helps you spend less time on administrative work and more time offering great care to your clients. Visit helloalma.com backslash A-T-P-P

 

27:10

or click the link in the show notes to learn more. And I like what you were saying, like, there's a curiosity that you're bringing. It's not  like you're looking at them saying, hey, you're criticizing your partner, you need to stop doing that because it's not healthy communication,  which would be like, you know, a teacher telling the students what to do, like, you know, the right way of doing things.  It is more like curiosity, like, hey, what's...

 

27:36

How's that feel for you? What's going on for you? And they're talking like that. And what's going on for you as, know, maybe you should be curious with your partner about what's happening for that, you know, and you're sort of helping them, guiding them through the, it's a relational experience between the two of them. Exactly the word. Yeah. It's highly experiential and it would be much more what's going on with him, what's going on with her, what's going on with them for you to figure out, to build that sensitivity, to build that operator's manual. And we'll do  all kinds of stuff.

 

28:03

So it can be that or it could even do, I think a lot of therapies do this. I'll pull my chair over next to the person and be Cyrano and whisper. I don't know if that's the right reference, but whisper,  say this, say this and see what happens. And I love you and miss you so much and see what happens and look at the way they melt. Wow. That's exactly what you wanted, isn't it? What do you to do? It's happening inside of you  and kind of move people around. We do a lot of, so the rolling chairs are for a reason because we know attachment impacts,  proximity seeking and contact maintenance.

 

28:32

We want to play with the distance between two people. want to play with touch. We want to understand how these things are going. So I can move people to kind of collect data and test out hypotheses. And I can also move people so that they have different experience because we want them to have a different experience. We'll do posing. We have impactful poses that we put people in that will kind of conjure different feelings, sensations, different points in time, different memories. So we can rewrite some things. It's very fun. Yeah. And when you're

 

29:00

Starting off with the partner attachment inventory, mean, is there a way that you're  relating the  past experiences to the present day dynamics in the couple? Yeah, usually in the debrief people are like, oh shit, I'm doing exactly the same thing my parents did. Oh man. And then they want to change it. Quite often, it's a literal connection between it.  Sometimes it can be a bit murkier.

 

29:27

Um, and it can take a while to get through based on, depending on people's, people's history, but generally,  I mean, that's one of the things I like about couples therapy, even though it's complex, it's not complicated. There's a million moving parts, but at the end of the day, everyone wants to be seen, heard, loved, validated, respected.  And we have this great framework that shows us how we operate. So you can see patterns and they can translate through. And usually people don't want to repeat patterns. That's why they're in couples therapy.

 

29:58

Yeah. And I think as a therapist, when you work with couples for some period of time, you begin to see a lot of commonalities and the things that people want and, and impact you. I mean, I like having sort of like grounding principles,  like the things that you talked about with the secure principles of secure functioning. Like people really need safety. People really need to feel like there's justice. People really need to feel like they're collaborating.

 

30:25

all of these,  those are really grounding, right?  It can really be helpful to sort of figure out which of these areas are people struggling in  because that's probably, it will get you the most progress the most quickly. Yeah, and we do tend to move quickly in PACT. think that's one of the things that kind of  differentiates it from other therapies is that we can make quick progress, especially also because it's experiential, right?

 

30:51

So I want you to be fighting in front of me like you do at home. And I want you to have a different experience here in this office. How would you talk about, so, I mean, you talked about the accountability, which is taking personal responsibility.  How would you talk about the idea  of the difference between creating safety for myself versus partners helping each other create safety? Like, in other words, and I think you sort of,

 

31:20

touched on it a little bit. I  often feel like both people are waiting for the other person to create safety before they're going to dive into the water.  They're hesitant.  I have found that I think it is helpful  to step away,  to say, you know what? don't need my partner to do anything in order to create safety for myself. How am I creating safety for myself to enter into this conversation so that my partner can

 

31:50

respond however they're going to respond, but I'm still sort of regulating myself in the situation. Now in healthy  partnerships that eventually evolves into  sort of helping each other, feeling like if my partner is making an effort that can really snowball and we can try to help each other with the safety piece.  I think  in the way that I've heard some therapies talk about it,

 

32:18

It feels more like codependence to me where it's like, well, we're providing the safety for each other as sort of a reparative experience of what I didn't get from my parents or something like that.  My partner is now providing for me, but I like,  tend to lean a little bit more toward the accountability for self aspect of it. Yeah, it's a, it's a great question. It's important. One of the differentiators of PAC, like I said, if you were to call it, it's a lot of things, but if we were to call it three things, it was it's

 

32:47

attachment, a resolution regulation and neuroscience. So we focus greatly from the beginning on co-regulation. We want people to move to co-regulation and not codependency, like you said. So I'll back it up in that when it comes to the building that individual sense of safety, often I'll see this more in people who have lean more towards an anxious attachment style because you see when they are dysregulated, they'll flail and they want they need  some external source.

 

33:16

to regulate them. A lot of those protest behaviors and that criticism and blaming comes from that discomfort, right? So if I can get some sort of connection in some way, then it's gonna soothe me. So  those people have a little bit more work to do  in learning self-soothing strategies. But in general, we focus on co-regulation. And it's really important exactly what you said, that it's not,  I'm here to be your therapy dog, but I can recognize when you're distressed.

 

33:43

And I know that when you're distressed, we're not going to get anywhere.  So we say as soon as you  learn what it looks like when your partner gets outside of their window of tolerance or is kind of nearing that, your job is to drop it and move to soothing because we know that you're just not capable of coming to resolution or repair when you're outside of that window. So big focus on that.  Slow that  down a little bit. Focusing on soothing. Are you talking?

 

34:09

about one person soothing themselves or you're about the other partner noticing it and helping soothe their partner? Both, I think it's the... So in this specific example, it's we're in conflict, me and you are in conflict. I see that your face is getting all red and you're  tensing up and you're starting to get to these things. And I know  and I catch it. I know that means you're starting to get dysregulated. So I'm going to make the wise choice to say, on, Shane.

 

34:35

looks like you're upset or whatever the agreed upon languages that we have, right? Because we have agreements for absolutely everything. Because maybe me saying, it looks like you're upset is going to piss you off more. But we've said, hey, turkey pineapple and you know, oh, I'm getting dysregulated. So I'm taking the initiative to say, it looks like you need some soothing here. Let's do whatever it is that you need. And maybe if you're more avoided, it means you need to go sit down for 10 minutes by yourself, or maybe you need a hug, whatever it is. Because we've also figured that out because I know what your operator's manual is.

 

35:05

And then once we're soothed, then we'll talk about what the issue is. So we definitely do place emphasis on co-regulation. Um, we want you to be each other's source of safety, but it's with, it's with boundaries. It's with knowing that I'm a, it's with knowing that I'm a separate person. It's knowing that I'm not responsible for your feelings in any way in the same way that me as a therapist, I'm lending out my nervous system to my clients, but I'm boundary. I'm not taking their things on same thing. Yeah.

 

35:35

Yeah, great. Yeah. And I love the language of boundaries. Yeah. Because I think there's a fear for some people of like, well, if my partner is yelling in my face and calling me names, you're saying that I'm supposed to be the one to sue them. You know, so  and  that's not what you're saying. I just want to make it clear for people, you know, that if that if I felt like that was happening to me, I was being yelled at and being called names.

 

36:04

that I have the right to say, listen, this isn't working for me.  Let's take some space apart or something like that to set a really clear boundary separate from the situation. That also fits with our principles though, right? Because that's the best choice for the relationship.  Yeah, absolutely. Yeah, if you let that carry on, if you choose to participate in that, to continue in that, then you're saying that within our relationship, this is how we operate, right? But you saying, hey, you can't call me names. I'm not going to do this.

 

36:33

is mutuality. It's good for me. It's good for you. You don't I love you. I know that you're a good person and you don't want to show up in this way and you're going to feel real bad about this. That's right. Yeah. So let's stop. Great. I have, I've also found that to be incredibly helpful. You know, when people can get to a place where they're communicating, like their nervous systems are regulated, where both people are relaxed, that that's the time.

 

36:59

to really set up the agreements and set up the plans together and say, look, the next time,  we know we're gonna get into a really heated situation again at some point. And the next time that happens, here's what I'm gonna do, here's what,  or let me understand what would be most helpful for you, here's what would be most helpful for me. And just sort of making that plan together and agreement together and feeling a lot more confident about  dealing with it once the situation comes up. Yep, absolutely.

 

37:28

And then you can imagine too, for some people that's really difficult. For some people when I say, well, what do you need? They're like, I have no idea. I've never been asked what I need. I've never been, it's never been taken into consideration. So, you know, on its face, it sounds simple that we can say, okay, what are you going to need? And we can big bang boom talk about it. But that conversation itself can be a sensitive one where we have to go through it and we're looking at, and like that can be an intervention in itself. That for the first time, someone is showing up and saying, what do you need? And putting your faith in them that they're going to.

 

37:57

show up with what you need and going through those things. So, and then we shake on it and say, okay, this is what we're to do.  And then there's a lot of hope in all of this, right? So, okay, we agree. Let's see what happens when we do it, but you're much more likely to be able to do it when it shows up. If you've already, like you said, made those agreements at a time when you're both common regulated. Yeah, absolutely. And I think if there's someone who doesn't know what they  has a hard time knowing what they need, which is a lot of us, especially in the heat of the moment, they're not going to be able to process what's going on.

 

38:26

No, just need you to go away.  Yeah,  exactly.  But I feel like PACT really provides an environment that helps them finally feel like someone's holding space for me to think about what I need. Once you get into it, at least, maybe not the first session, maybe, but  that over time, it still might be hard for people who have a hard time knowing what they need.

 

38:55

that might be something for the rest of their life. But I think it gets easier when you feel that safety, when you feel that ability to listen to each other  and feel valued by each other. Yeah. And  it does often happen early on. So in PACT, we simplify attachment  and  we say three things. So secure we label as anchor. Avoidant we label as island. You can imagine why.  And anxious we label as wave. You can imagine why. So if you picture it, right, you can see the avoidant is the island.

 

39:25

And then the anxious wave is just crashing, crashing, crashing over it, protesting, blaming, criticizing, reaching, trying to get closer and closer.  So we do talk about having to rescue the island from the wave often, particularly in the beginning, so you can make that space. Because again, people act against their best interests. The wave just wants that connection so badly,  but they're drowning their island partner. So we kind of have to hold everyone steady for a little bit and make that space.

 

39:52

and then I'm modeling and teaching the wave how to hold space for the island and do it themselves while they're holding space. Yeah. And is that part of the idea of the therapist as master regulator? Part of it. Yeah. The therapist is master regulars more so playing with the temperature in the room and also me being super regulated because it's, you know, couples therapy puts all your shit right in front of you in real time constantly playing with the temperature in the room.

 

40:20

Because we're looking at arousal and regulation,  so I'm looking at assessing what's the arousal in this couple. You can have a couple who they're both high arousal. You can have where they're both low arousal. So for example, I think it's easiest to see if a couple is both low arousal. So that's the couple that comes and sits in and they just kind of stare at each other. But there's not a lot for me to do there.  So I need to play B master regulator and I need to the temperature up. We talk about  locate and amplify pain. So I'm going to figure out.

 

40:50

what's there and I'm going to put my thumb in it and I'm going to make it hurt because I can't work with nothing.  So we got to figure out what that hurt is. So I'm going to change the regulation  so that they can have that different experience in the session.  Oh, okay. Yeah.  Because they can just sit there and we can all say nice things to each other and they can say and they can use I words and talk about their feelings. But if there's not regulation  and affect and arousal  change tied to it.

 

41:16

It's not a different experience. My nervous system still is operating from the same way that it's been taught to operate. So I need to change, to play with arousal regulation in the room so that you have a different experience. So we can kind of re rewire some of those paths. As you say that, I'm thinking like it's really helping them move into authenticity.  Like,  uh, it can't, or it can be, I mean, and I've had to,  to  a couple where both people are really avoidant and sort of.

 

41:46

polite, you know, and it's like, why are they, what's the problem here? Right. And like, we need to help them move into that authenticity if we can. Yeah. Which leads to intimacy, right? So, yes, you're right. Right. That's one of the lovely things that I really enjoy when I've been working with a couple for a while and they kind of, you know, we start, we start with more sessions at the beginning and they fade out and then I'll have people who I worked with a year or two ago and then they come back for these other issues. And it's, it's really them reaching these really

 

42:16

deeper, beautiful levels of intimacy because now they've moved past that politeness and they have that sense of safety and they trust enough to know that if I show up in the way that I need to show up, my partner's gonna be there for me, right? Like the way EFT says it, it's reach and respond. But we're putting in that level, it's the brain and the body because we can learn all the things we want, we can learn all the I-statements, we can do all the psychoeducation, but if my body feels like it's set on fire anytime you get close to me because of the experiences that I have, I'm not gonna be able to do it.

 

42:46

Yeah, and I don't know what kind of language PACT  uses, but it sounds like there's almost some somatic elements,  know, like helping people slow down, helping people sort of get into their emotions, create space  for their embodied experience of what's happening. Yep, absolutely. And that's where some of the posing comes in. Like one of my favorite poses is called lover's pose. And it's where one person sits upright on a couch, the other person lays down with their head in their lap.

 

43:15

much as you would have done when you were a child, right?  But you can already imagine what may come rushing back in when your body is put in that position, especially for men in heterosexual couples. If the wife is the one sitting upright and the  husband is the one to put his head in that woman's lap, like you can just imagine what kind of memories it might conjure where it would take you back. And this is a full body experience, right? Yeah. I think the research shows that that kind of...

 

43:42

nurturance  goes away for little boys much sooner than it does for girls oftentimes. Yeah. Yeah. And it's very vulnerable position to put yourself in,  To lay down like that, to put yourself in kind of a childlike position, to change the power dynamic in that way. It'd be interesting for men listening to that to think about like, when's the last time you did that? When's the last time you laid down and put your head in your lover's lap like that? Yeah. Yeah. And then during that, of course, I'll coach them through language. I'll feed language and depending on what the situation is to...

 

44:12

surface what's going on and then we can do a lot of rewriting within that. It's lovely. Yeah. Well, and I love the encouragement for people in your therapy office to  be able to connect like that. Right. I think a lot of times even in couples therapy, it can feel a little bit like, we're in an office building where, know, we're sitting on separate sides of the couch  and you know, we have to have some professional sort of

 

44:39

attitude about how we're approaching this and it's like those kinds of interventions are extremely helpful sometimes like the one you were just describing.  Yeah, well even so far as necessarily a bed but maybe like a little pullout sofa because a lot of like if we're talking about sex and if we're talking about physical intimacy we want to stage things so that you're actually having  the somatic experience of  what goes on. My heart is going to start pumping when you

 

45:08

get in bed next to me and put your arm around me.  It's a loaded gesture for me. So I want to stimulate that physical experience so that we can work with that. Otherwise it's kind of like a pseudo response. Yeah, great.  Any other  final thoughts? Just that I hope more people can get trained and packed.  think it's a really complete,  especially people who are doing couples therapy, I think it's a really complete method.

 

45:32

As I've said, it's so enjoyable to practice as a therapist and it's really effective, which is great. I know that I've helped people,  which is an interesting shift coming from  what I shared with my background. think a lot of people, when they work in policy and they work at the macro, the mezzo levels, they want to, they feel like they're making meaningful change because it's big change. But I know in the last few years that I've been practicing PACT, I know that I've changed people's lives and it's such a privilege to be able to do that. Um, so I hope more people will look into it.

 

46:00

The PACT Institute is looking to train more people and they're  also looking to train people from different walks of life and to be more inclusive and be more accessible. So they offer scholarships, they offer  different rates based on your currency, where you live to try to get more people trained because right now it's mostly focused in the US.  It's a big white population of people who are practicing it, but Stan and the PACT Institute absolutely want more people to be practicing this because they know its value. Oh, great. Good.

 

46:30

And I'll put the link to the website there. And how can people find you? What's your website and anything else? We're at TheRelationshipAgency.com. am on Instagram @Relationships.Are.Everything but I really hate social media. So I'm just like intermittently on there. Yeah, no problem. You can DM me, whatever. I'm around. I'm happy to talk about pact and couples therapy anytime. I love it. Yeah, great. Yeah. Thank you so much, Michelle. This was, this was a great conversation. I feel like, uh,

 

46:59

It's a great introduction for people to PACT, and I really appreciate you taking the time to come on. Thank you. Thanks for having me. Love it. The episode this week is brought to you by Alma. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates. Alma handles all of the paperwork and guarantees payment within two weeks.  Visit HelloAlma.com/ATPP  or click on the link in the show notes to learn more. And thank you again, everybody. This is Shane Birkel, and this is the couple's therapist couch.

 

47:29

podcast. It's all about the practice of couples therapy.  I hope you have a great week and we'll see you next time.  Bye, everybody!