301: Longer Therapy Sessions with Shane Birkel

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 solo episode, Shane talks longer therapy sessions. 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.

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• Show Notes
• The Couples Therapist Couch Summary
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The Couples Therapist Couch 301: Longer Therapy Sessions with Shane Birkel

This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice 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 solo episode, Shane talks longer therapy sessions. Hear why couples therapists need to be working in longer sessions when meeting with couples, what to do if you run out of time in a couples therapy session, why you should focus on the betrayer first in an affair, why couples therapy is a very difficult art form, and how long couples therapy intensives should be.

Here's a small sample of what you'll hear in this episode:

• It's not the therapist's fault, the container might just be too small
• The little voice that says "am I allowed to do this?" and how Shane worked through it
• How an emotional shift allowed the betrayed partner to finally be heard
• Intensives don't have to mean six hours 
• When something finally opens up but there's only 7 minutes left 

Show Notes

• 301: Longer Therapy Sessions with Shane Birkel
• This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice to learn more
• [0:30] Why Shane believes couples therapy needs to move toward longer sessions
• [1:28] When something finally opens up but there's only 7 minutes left
• [2:24] It's not the therapist's fault, the container might just be too small
• [3:49] A case study: a wife who discovered her husband's emotional affair, and what a six-hour intensive made possible
• [5:15] The affair as the latest version of a pattern that was already there
• [6:15] His two default moves when she was in pain 
• [7:13] The difference between shame and healthy guilt, and why it matters in this work
• [8:13] This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice to learn more
• [9:12] Why Shane focused on the betrayed partner first and what that required from the other partner
• [10:07] Going into his family of origin 
• [11:32] The moment he realized he was never responsible for his mother's happiness
• [12:28] How his emotional shift allowed her to finally be heard
• [13:25] How the four C's (consciousness, curiosity, compassion, connection) apply to intensive work
• [14:22] Intensives don't have to mean six hours 
• [15:20] The real barrier isn't clinical, it's the belief that therapy only belongs in a 50-minute box
• [16:13] The little voice that says "am I allowed to do this?" and how Shane worked through it
• [16:40] Free live training on October 2nd for couples therapists interested in working this way
• [17:09] A new six-week live training for therapists who want to learn how to offer intensives
• This episode is brought to you by Alma. Visit https://helloalma.com/dg/?utm_source=podcast&utm_medium=paid&utm_campaign=privatepractice 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

Please note: this transcript is not 100% accurate.

00:00
And now having done this work for years, the funny thing is I don't even worry about having too much time. I, you know, we usually get to the end and I feel like I need more time.

00:14
Welcome 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 Burkle.

00:30
Hey everybody. Welcome back to the Couples Therapist's Couch. This is Shane Burkle, 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.

00:59
Alma handles all of the paperwork and guarantees payment within two weeks. Visit helloalma.com or click on the link in the show notes to learn more. I'm really excited to talk with you today about how I've been working. If you listen to the podcast, I've been talking about this for quite a while. And it's something that I think is one of the most important things that I've come to in my own practice, which is

01:28
the idea that we need to be working in longer sessions when we meet with couples. And every couples therapist knows this moment when you're 47 minutes into a session, finally something just opened up. The real thing underneath the argument is finally showing itself. And then you have to say, oh, I'm sorry, we're out of time for today. And sometimes I think we...

01:57
blame ourself. You know, I, I do a lot of teaching in the couples therapist inner circle and I do a lot of consultation with other therapists. And I think a lot of people think that like they, they, as the therapist is the problem. Like I didn't know how to deal with it or I didn't know how to get to the heart of it quick enough. When I did my first intensive training where I was training other therapists, how to do it couples therapy intensives.

02:24
One of the therapists said when she has 50 minutes, she was like, you know, I get to the point where I have 10 minutes left in the session and I don't even know what to do anymore because I don't want to open up more wounds that is going to create a conversation that we don't have time to have. And she's like, if I had four hours, I'd have plenty of things to do in the session. Uh, so it's kind of counterintuitive, but

02:50
I've started to question whether the problem is actually what we're doing or whether it's that the container is too small. So when couples are getting activated, it takes time to slow things down. It takes time for people to feel safe enough to get under the defensiveness or the anger. And once something vulnerable finally emerges, I don't want to necessarily wrap up

03:18
the session just because the clock says we have seven minutes left. I want to have enough time to stay with it, to understand it, to help people do something different with it. And that's the thing too. You know, you'll feel better as a therapist because you're doing good quality work. The people you work with, the couples are going to feel better about it because they're actually getting results. And, you know, I just think it's the direction that couples therapy has to move towards.

03:49
So I want to talk you through a couple that I worked with because I think it kind of illustrates exactly what I mean. And I often do, I often set it up where I do one full day with a couple and you know, we might have a intro session before that or some, a few follow-up sessions after, but basically the first time I meet with the couple is for six hours in one day.

04:19
And that was the case with this particular couple I was working with. was a husband and a wife. And she had found out about an emotional affair that he had been having with someone else. And obviously, I would never justify that. But it was someone who made him feel good about himself without the vulnerability that

04:48
true relationship requires that his marriage required and you know his part his wife was feeling really hurt and angry and she was someone who was already someone who wanted to talk about the problems who wanted to work through him and he historically became defensive or Kind of shut down or try to explain it away

05:15
And so they already had this dynamic in place even before the affair happened. And this is something I talk about a lot with couples. A lot of times the affair is just the latest version of the same pattern. And if it's an affair, it's magnified. Whatever the pattern was before, it's much worse now because there's this huge emotionally charged hurtful thing that has happened.

05:46
But the first question I always ask is the same, what do you really want? And she really wanted to feel seen and heard and started crying just being asked that. I think there's a lot. Anytime we're talking to someone about that, there's the latest things that are happening. But there's also all the history. And people aren't fully conscious of that necessarily. there's a lot of emotion.

06:15
connected to these questions, not just about the present, but connected to so much of the history and the relationship. So his default to her pain was one of two moves. He'd either explain it away or he would collapse into so much shame, the conversation became about how bad he felt. And both of those were a way of not staying present with her. Those are both emotionally avoidant

06:43
Strategies I would say I make this distinction with couples a lot shame the distinction between shame and guilt shame says I'm a terrible person and it pulls the attention back onto how bad I feel Where healthy guilt says I did something to hurt you and I can stay right here with that because I care about you I feel bad because of your pain

07:13
And that's what she needed in this case, someone who could hear her pain without her needing to manage his. Another thing that you could say is that if someone is having an affair, they're preoccupied with what they want. It's all about them. And then when their partner feels betrayed and tries to express the hurt and pain and they go into shame,

07:43
then they're again becoming preoccupied with themselves. And so there's a lack of ability to connect with their partner's experience. It's sort of like when people have enough ability to have compassion for their partner, they don't have an affair in the first place. Having an affair is a way of avoiding the true issues in the actual relationship. Building a private practice can be challenging.

08:13
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. They also handle all of the paperwork from eligibility checks to claim submissions and guarantee payment within two weeks of each appointment.

08:41
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 or click the link in the show notes to learn more. So at some point, I don't want to make this an episode that's about working with affairs, but

09:12
There is something that I talk about a lot, is that we need to focus on the person who's been betrayed. We need to focus on the present day sort of betrayal as the first starting point, creating space for that person to feel heard and seen and understood and to sort of process the trauma of the affair that they found out about. But a lot of times what happens is you'll find

09:40
The other partner isn't capable of doing that. So sometimes it leads to working on the other partner's ability to listen or to create space or to work on their own self-esteem so they can show up for their partner in the way that they need. Cause this is going to be a long-term process and we have to sort of begin to lay the foundation. So when I tell you, you know,

10:07
Pretty early on, I went into his family of origin. You might be thinking, and rightfully so, well, why are you focusing on him if she was the one who was betrayed and hurt? So that's why I explained all of that. It's not to sort of explain away the affair, but to understand why staying present was so hard for him. And when we did that, we found his parents fought constantly.

10:36
He learned early on that when someone he loved was upset, it was his job to fix it or to disappear so he wouldn't add to the burden. And that's the same move he'd been making with his wife for years, explain it away or vanish into shame. And understanding that wasn't at all about letting him off the hook. It was about making him capable of finally hearing her and staying present with her pain and being

11:05
beginning to be accountable for what had happened. So at one point I said to him, you you felt this huge responsibility for your mom's wellbeing as a kid. You were just a sweet little boy, but you were never responsible for her happiness. And he got emotional and he said he'd never thought about it that way. And again, that moment didn't excuse anything.

11:32
What it did was let him stay in the room for what came next. And, you know, this is a very difficult art form, I guess you could say. It's like the art and science, as the Gottmans talk about it, of doing therapy. Because how do you do this kind of work with the person who had the affair?

12:00
while keeping their partner sort of in the context of what's happening and making sure you're serving the other partner, which is in some ways more important because they've been betrayed and hurt by this other person. And that can be a very hard thing to hold all at once. And when it works well, it works really well and it makes sense. And

12:28
you begin to feel that this person who had the affair is connecting with emotions that they should have done before the affair happened. And it's very reassuring to the partner, again, when it plays out well. So because he was able to do that, he was then able to do something more difficult. He was able to stay present while she told him,

12:56
exactly what the affair had done to her. Right? So that's what all of that was leading up to. And again, there's no way this could have happened in 50 minutes. It was just so important that we had the extra time, but he was able to stay present with her without deflecting, without collapsing into his own shame. And that's what she'd been asking for their whole relationship, not an apology that made him feel better.

13:25
but someone who could actually be there for her. Again, this is oftentimes with affairs, this is just the beginning. You know, they're going to need several months of being able to do this with each other to heal and to repair and to rebuild the trust. So another thing is that this is what I mean when I talk about the four C's, consciousness, curiosity, compassion, and connection. His consciousness,

13:53
of what was really going on inside of him didn't replace his accountability. It's actually what made accountability possible. So could pieces of this happen in traditional weekly therapy? Of course. I've done weekly couples therapy for years and there's something very different about not having to stop right when he's finally staying present instead of defending or disappearing. And the other thing is that when I say intensive,

14:22
I don't necessarily mean six hours. I've done two hour sessions, three hour sessions, four hour sessions, full day intensives, and sometimes more than a day. The larger idea is that we don't automatically have to assume that couples therapy belongs in a 50 minute box. And a lot of times people are worried, you know, what am I going to do during that whole time? And that's where the four C's can be very helpful. If you haven't heard those episodes, you can go back and listen to them.

14:49
But it's sort of, the four C's are a way of grounding you in the work so that you know what to do at any point. So that no matter how long your session is, you always have a way to sort of feel like connected back to what are we doing here? What's most helpful? What do we need to be conscious of? What do we need to be curious about? Where are we struggling with compassion or where are the people we're working with are struggling with compassion? All of those things.

15:20
You know, one of the biggest barriers I don't think is clinical at all. You know, I think, like I was saying before, I think a lot of couples therapists receive good training. They have experience, they know what they're doing, but they feel like it's their fault when they can't get the work done in a 15 minute session. But

15:43
Most of us were trained with this idea that therapy is supposed to be 50 minutes every week, and that's just what it looks like. So I want to give you permission to start thinking about it differently. When you start thinking about seeing someone for three hours or six hours, there's a little voice. I've heard people say there's this little voice in their head like, I allowed to do this? Is this really therapy? Will clients pay for this? What are other therapists going to think about this?

16:13
What am I going to do with them for that long? And I've had to work through all these questions myself. And now having done this work for years, the funny thing is I don't even worry about having too much time. you know, we usually get to the end and I feel like I need more time. So if you're a couples therapist listening to this and thinking, I've been feeling this too. I've been, I've been doing the weekly sessions for 50 minutes, but I've been feeling like I need more time.

16:40
I'm going to be doing a free live training on October 2nd at noon Eastern time, specifically for couples therapists who are interested in this way of working. And I want to teach all of you how to do this again for free. I just want to help couples therapists begin to work in this way and give you a little bit more insight into what actually is happening during the intensive and some of the clinical and practical things you need to think about before you.

17:09
you wanted to begin offering them in your own practice. So I'll put the registration form in the show notes and over the next several weeks, I'll be talking a lot more about this. I'm also opening a new, a six week live training for couples therapists who want to learn how to do this work. But you know, whether or not you ever take the training, you can do the, the listen to the podcast, do the free training. I just want you to start thinking about what might become possible with some of the couples. If you weren't trying to fit it,

17:39
into the 50 minute framework. All right. Thanks everybody. I hope you have a great week and I'll see you next time. 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 or click on the link in the show notes to learn more. Thank you again, everybody. This is Shane Burkle and this is the couple's therapist couch.

18:08
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.