Common Impasses - EFT Couple Therapy Switzerland

De-escalation impasses are often caused by:

Deep-seated psychopathology in one or both members of the couple.

A lack of softening in one or both partners.

Failure to identify the cycle and access the underlying emotions.

Failure to engage the pursuer.

All of the above

De-escalation impasses usual involve:

The couple remaining in their rigid, reactive attack–defend cycle.

The couple being too busy to work on their marriage

The couple having too many children.

The couple having family of origin problems.

All of the above

In a de-escalation impasse it is generally helpful to:

Reframe actions such as attacking or withdrawing as being because the partner cares so much, needs and is impacted so intensely by the other.

Use metaphors to capture and crystallize each person’s experience in the cycle.

Work to improve the alliance with both partners.

Work to access and have the clients express primary emotions that are driving the cycle.

All of the above

In getting a couple to de-escalate, it is usually helpful to:

Allow and even encourage them to fight so that they get the emotions out so the therapist can work with and deepen them

Keep things light and happy in session through the use of humor so they don’t fight and will experience the relationship differently

Focus on using the basic interventions of empathy reflection, empathic conjecture, evocative questioning, validation, etc., to help them experience all levels of the cycle, especially the primary emotions

Warn them that if they don’t stop this pattern, their relationship is doomed.

All of the above

In getting a couple to de-escalate, it is helpful to:

Teach each partner about the other partner’s primary emotions.

Assign the couple to do some type of ordeal that will help them give up the escalating pattern of conflict.

Do emotionally oriented reflective listening exercises.

Warn them that if they don’t stop this pattern, their relationship is doomed.

Examine the strength of your alliance with each partner and work to deepen it.

What are likely to be the primary emotions for Natasha?

What are likely to be the primary emotions for Ruben?

Which of the following interventions would probably not help slow down the interaction?

Evocative responding

Reflecting the cycle

Empathic conjecture

Reframing

Enactment

What type of intervention might help make the impasse explicit?

Evocative responding

Reflecting the cycle

Empathic conjecture

Reframing

Enactment

10.

Write a sentence or two that might help make the impasse explicit. Compare your answer with the example given in the answer section

11.

How could the therapist set up an interaction to help make client responses that contribute to the impasse explicit and deepen them?

12.

An impasse involving withdrawer reengagement is most often caused by:

The withdrawer deep down being afraid of opening up and engaging

The withdrawer deep down being ambivalent or conflicted.

The pursuer being angry

The pursuer withdrawing.

All of the above

13.

A withdrawer reengagement impasse usually involves:

The withdrawer engaging actively in the therapy process except when the pursuer is attacking.

The withdrawer not engaging actively or sharing emotions regularly in or out of therapy

The pursuer being angry

The withdrawer not actively engaging or sharing emotions outside of therapy, but being open and actively sharing within the safety of the therapy room.

All of the above

14.

When the impasse involves the withdrawer not reengaging, it is generally helpful to

Mimic the pursuer to illustrate the cycle to the withdrawer.

Do a genogram on the withdrawer’s family to determine intergenerational patterns of withdrawing.

Work to strengthen the alliance with the withdrawer and use the basic interventions to try to access fears or hurts that may be underlying his failure to engage

Encouraging the client to do thought exercises three times a day where the client imagines being open and engaged.

All of the above

15.

When working with an intransigent withdrawer impasse, it may be helpful to:

Meet with the withdrawer individually to see if there is something related to the impasse that is not coming out in the couple’s session

Do an attachment history to highlight safe attachment relationships, identify attachment injuries, and examine attachment models and experiences.

Do a disquisition about a previous client who could not risk engaging and so he pushed his wife away and was left all alone

Watch a tape of the couple’s session and look for patterns, missed opportunities, alliance issues, and times where the withdrawer may begin to engage.

All of the above

16.

When working with a withdrawer impasse, it may be helpful to:

Do a careful assessment for depression and if found refer the client for medication.

Let the couple know that the withdrawer has been so damaged by previous attachment traumas that it is not likely that there can ever be healthy engagement.

Work to make the therapy room as safe as possible in order to access and explore underlying emotions in the cycle and ensure the couple remains deescalated.

Watch a tape of the couple’s session and look for patterns, missed opportunities, alliance issues, and times where the withdrawer may begin to engage.

Do individual therapy until the cause of the withdrawing can be found and healed

17.

What types of fears might be holding him back?

18.

If he is afraid of her anger, what are five ways to reflect this fear in order to deepen it?

19.

Softening impasses are usually caused by:

Personality disorders.

Fear of being hurt again.

The therapist accessing too much emotion too early in the therapy

The withdrawer being fully engaged and present, which creates fear in the pursing partner

All of the above

20.

Softening impasses usually involve:

The couple remaining in their rigid, reactive attack/defend cycle

The withdrawer being present and engaged and the pursuer continuing to blame, criticize, and attack as if no change had occurred.

The pursuing partner having family of origin problems that must be resolved to move forward.

Poor communication skills training.

All of the above

21.

In a softening impasse it is generally helpful to:

Do individual therapy with the pursuer until there is a change.

Let the pursuing partner know that he or she is responsible for the impasse and that no change will occur unless he or she stops pursuing.

Slice the emotions and action tendencies thinner so that the both members of the couple and the therapist gain an experiential understanding of the block.

Do a role-play where the therapist attacks the pursuer so that the pursuer knows how the partner feels.

All of the above

22.

In a softening impasse it is generally not helpful to:

Make the impasse explicit

Seek out supervision or review tapes of the session

Evaluate the alliance and work to strengthen it if it is weak.

Heighten underlying emotions in the pursuer in order to help the pursuer soften through touching his or her vulnerability in the presence of the partner.

All of the above

23.

In moving beyond a softening impasse, it is sometimes helpful to:

Encourage the pursuer to blame and criticize more to get the emotions out.

Challenge the irrational aspects of the internal working model of the pursuer.

Do family-of-origin work and teach basic listening skills.

Do an attachment history to identify and work though attachment-related injuries and traumas in current or past relationships.

All of the above

24.

What might be the underlying emotions that could be preventing her from softening?

25.

How would you describe the cycle for Jose and Rosita at this point in therapy? Feel free to fill in details that are needed to complete a description of the cycle

26.

In trying to get Rosita to soften, you do an individual session with both Rosita and Jose. What types of interventions and topics would you focus on in your individual session with Rosita?

27.

What types of topics and interventions would you focus on in your individual session with Jose?

28.

Write a possible disquisition for Jose and Rosita designed to help her soften and reach for him.

29.

Generalized impasses are often caused by:

Competing attachments

Failure to correctly identify Axis I or II disorders

The birth order mix of the couple

A lack of passion in the marriage

All of the above

30.

Generalizing impasses usually involve:

The couple hating each other

The couple making progress in session but not taking risks outside so the progress does not generalize to the relationship outside of the therapy room.

The couple generalizing the problems they are experiencing from being caught in the cycle to the character of the other partner

The couple having difficulty accessing or even being aware of their general emotional state.

All of the above

31.

With a generalizing impasse, it is usually helpful to:

Assign reflective listening homework so they practice the skills they are learning inside therapy to the outside world

Carefully assess for things such as competing attachments, addictions, or violence that may have been missed in the initial assessment

Do a genogram to look for an intergenerational pattern of failure to generalize.

Assess for internal splits in one or both partners.

All of the above

32.

With a generalizing impasse, it is usually not helpful to:

Do an individual session to better assess for things like hidden violence, addictions, or affairs

Work to heighten primary affect to clarify their way of interacting outside of therapy sessions.

Assign them to make a chart of how often they fail to connect outside of the therapy.

Carefully assess all levels of the cycle that occur outside the session.

All of the above are helpful to do with a generalizing impasse.

33.

In moving beyond a generalization impasse, it is sometimes helpful to:

Encourage them to engage in the negative cycle more intensely outside of the therapy room so that they will gain a greater emotional understanding of how destructive it is.

Work to help each partner experience the other person as caring (assuming this is an issue and the other person really does care).

Assign them to practice doing kind behaviors for each other outside of therapy.

Assess for internal splits in one or both partners.

Assign them to spend time each day expressing their emotions to each other.

34.

What might some of the underlying emotions be around the impasse?

35.

In this case, the therapist wondered if there was something that was missed in the assessment that could be related to the impasse. What types of things would be helpful to reassess for?