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Ruth Cohn
   
Minding the Body in Couple’s Therapy Part 2:
Letting Physiology Be Our Guide

As a passionate couple’s therapist, I have long been an admirer and student of John Gottman. For thirty years he has been doing longitudinal research and collecting data on relationship and marriage. He is creating a science of understanding the elements that make for successful, lasting partnership and what factors predict separation and divorce. Marital therapy has been ineffective in slowing the persistently alarming divorce rates, and Gottman is also trying to do something about that. In recent years he has become well known in the larger world of talk shows and popular magazines, because his subject is of interest and concern far beyond the world of therapists and researchers.

As a body oriented psychotherapist, I am especially interested in the central way physiology figures into Gottman’s research and thinking about couples. In the laboratory where he observes couples, he measures heart rate, skin conductance and all extraneous movement during their interactions. He is a serious student of Paul Ekman, the expert on facial expression; and closely tracks body language. According to Gottman, a marked percentage of couple’s communication is nonverbal. And the body is an invaluable monitor of interpersonal dynamics. So it behooves us couples therapists to orient to the body, if we do not already.

Emotional Coaching and Affect Regulation

An interesting template for successful couple’s communication, is the optimal communication style for parents with children. Gottman has also studied children and the parenting styles that most enhance healthy development. In his research on families, Gottman identified three main patterns of “meta-emotion” or feelings about feelings, and three corresponding parenting styles. He identifies the three styles as emotionally dismissive; emotionally disapproving and emotional coaching. The emotionally dismissive parent minimizes or denies the child’s emotion. For example if the child is scared, the parent might say, “You’re not scared. This is fun.” The child thus becomes confused about her feelings, or gets the message that they have no value.

The emotionally disapproving parent might believe that anger is wrong or fear is wimpy. The child of this parent might get the feeling that his emotions are something to be ashamed of or guilty about.

The third style is emotional coaching, which Gottman teaches. This view asserts that emotion is valuable and presents a potent opportunity for teaching and connecting. Emotionally coaching parents mirror the child’s emotion, validate it and name the feeling. After the child’s feelings are fully validated and the child feels understood, then is the moment for teaching or “adding a little something.” The research shows that children raised in this style fare better in all measures: academic, relationship, affect regulation, behavior and autoimmune functioning. In fact in general, the experience in the moment of being validated and having feelings named, calms the body down.

If this manner of relating to children supports self regulation and health, it would seem to follow that something similar would be an optimal style for adults’ and couples’ communication.

Diffuse Physiological Arousal

Anyone who has ever been in an intimate relationship knows that few people on earth can incite bodily arousal of all kinds, like the intimate partner. In both positive and negative ways our hearts can race; our faces can flush to lobster red; our chests can fill to the point of bursting, our genitals can tingle, throb or go numb; we can be inspired to cry or scream or laugh. And our partners, like no one else can evoke a transference, and activate painful childhood memories. The intimate partnership is perhaps more family-like than any other sort of relationship and thus can readily inspire the emotional reactions of the original family.

Gottman has coined the term “diffuse physiological arousal” as the body’s expression of what he calls “flooding.” Flooding is the experience of being overwhelmed by one’s partner’s (or anyone’s) emotions. Diffuse physiological arousal (or DPA in the Gottman lexicon,) is the amalgam of bodily stress responses: accelerated heart rate, secretion of stress hormones, skin conductance, temperature changes, sweating etc. Most immediate is accelerated heart rate.

Gottman has identified that a heart rate of 100 beats per minute is the average cutoff (excepting among highly trained athletes where it might be 80-90) beyond which rational thought and conversation becomes impossible. Many couples develop a pattern where one partner approaches the other to discuss charged issues. The approached partner, overwhelmed by the intensity of the emotion presented, shuts down and withdraws, causing the original partner to be more frustrated than before. The emotion might then escalate further, the shutdown response increase, etc. This pattern may itself become a relationship issue. Awareness of flooding and of the beginning of a slide into DPA, can make for the possibility of prevention. In sessions, he might have couples wearing wrist heart rate monitors that begin beeping when their heart rates shoot over 100, so that they might learn to recognize what that critical mass feels like in their bodies.

The antidote to the full blown pattern, is early detection of signs of flooding; and giving the body an opportunity to calm down. It takes a good 20 minutes to calm down from a heart rate of 100bpm. Gottman teaches couples to negotiate breaks from interactions where flooding begins, always agreeing on precisely when partners will get back together to continue their conversation. In addition to less provocative ways of talking about feelings, self soothing and partner soothing activities and exercises are important skills for them to learn.


State Dependent Learning

If we want the impact of couple’s therapy to last beyond the therapy office door, it is important to understand the concept of state dependent learning. State dependent learning essentially means that information or skills learned in a particular mental or physiological state, are most readily accessed in that same state. This is one reason why it is so difficult to learn complex behavior changes from a book. If we learn the material in a calm, clear headed state and then try to make use of it in a hot-headed state of DPA, the valuable insight or skill might be nowhere to be found. This is why so often couples forget what they learned in couple’s therapy at the times when they need it most. And this is another good reason why it is so important to allow couples’ conflicts and dynamics to unfold in the office and before the therapist’s eyes. If we teach them the skills in a state of arousal, there is hope that they will be able to access what they have learned when they are at home and in a state of arousal.

Facial Expression

How many times I have seen an entire fight begin between a couple, as a result of an eyebrow, or some other variation of facial expression! One partner perceiving an expression on the other one’s face, might verbally or wordlessly react with horror, fear or defensiveness. Before you know it there is a full blown escalation, often without even a word spoken. The face is an awesomely potent organ of communication. Researchers on emotion like Paul Ekman and others, have discovered not only that there are universal facial expressions of specific emotions that span cultures and history (and even some non-human primates!) They have also determined that just as the emotion involuntarily activates the facial expression, purposely creating a facial expression can evoke the correllate emotion. This is another reason why mirroring is such a powerful empathic tool, and why many body oriented therapists organize their own bodies and faces in the configuration of their clients in a given moment. It literally creates a window into the client’s feeling.

Facial expression may be subtle and quick. One spouse or partner may perceive it even before the feeling has registered in the awareness of the observed other. It is powerful for a therapist to become fluent in the universal language of the face, to help clients learn to read each other accurately. And also to teach clients to be aware of what they communicate with their faces. It conveys a confusing message when the words and face are expressing dissonant or incongruent emotions. The same is true with body language, although that is a less precise science.

Physiology also communicates other emotional cues. For known evolutionary reasons, hot hands are an expression of anger. Cold hands are an expression of fear. For some of our alexythymic clients, who drive their partners crazy by not knowing what they feel, or believing they do not feel anything, body sensation can be the royal road to emotion and emotional awareness. Some of these more obvious body experiences, common to struggling couples, will provide vital information that will enable them to learn to be more sensitive to their own and their partners’ emotional life.

To sum up, even for those who do not consider themselves somatic or body oriented therapists, the body is an invaluable storehouse of information for both couples and their therapists. It makes good sense, and it makes our work much easier to make use of it!

References

Ekman, Paul, Emotion Revealed
2003. New York. Henry Holt & Co. LLC.

Gottman, John The Marriage Clinic
1999. New York. W.W. Norton.

Gottman, John, What Predicts Divorce?
1994. Hillsdale, NJ. Lawrence Erlbaum Associates, Inc. Publishers.

Gottman, J., Katz Fainsilber, L., Hooven, C., Meta-Emotion
1997. Mahwah, NJ. Lawrence Erlbaum Associates, Inc. Publishers.

Ruth Cohn, MFT is in private practice in Oakland. She specializes in individual and couple’s therapy with survivors of childhood trauma, neglect and their intimate partners and families. She is an AASECT Certified Sex Therapist, also certified in EMDR and
Sensorimotor Psychotherapy.

© 2005