[u09a1]_Amanda_McDermott_Intervention

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The McDermott Family Intervention The McDermott Family Intervention Amanda McDermott Capella University MFT 5820: Systemic Family Therapy Theory & Practice Prof. Bill Utesch June 11th, 2023 1

The McDermott Family Intervention McDermott Family Intervention When examining our couple seeking help in the McDermott family, a treatment model that might prove beneficial is Experiential Therapy. The couple we are looking at is Nate (husband, age 35) and Rachel (wife, age 34). In Experiential Therapy, there is a targeting of the emotional interactions and exchanges the couple has playing out between them with regards to the presenting problem ( Gehart, 2015). Some benefits of this model would include: a focus on communication, growth and the development of the individual along with their self-esteem, and an acknowledgement of roles played out within the family system, and their creative nature (Gehart, 2015). In replacing a therapy session where the problems and solutions are the focus, Experiential Therapy directs clients to focus on experiencing themselves in the unique situations brought about through the therapy process (Taylor, Springer, Bischoff, & Smith, 2021). Science lends greater credibility to this therapy process by showing just how much people spend using the left side of their brain consequently living in the past, or projecting their life in the future (Bailey, 2022), as opposed to dealing with the present. Intervention Description Nate and Rachel have become very intrenched in the impasse they have reached within their relationship. No longer do they see the other as the loving partner that they chose to wed in their early twenties. This has been replaced by a distorted, “impoverished version of themselves” (Papp, Scheinkman, & Malpas, 2013). The short-term goal for this couple is to create less tension and diminish the arguing they currently experience. The long-term goal is for the couple to either re-commit fully to their life together, or to start building new lives without the other party present. 2

The McDermott Family Intervention In relationships where couples have reached an impasse, we can be sure of a few things. In this case, the couple has co-created “molds” where they fit each other. All behaviors and interactions tend to re-enforce this mold and the negative self-perception that each partner has of the other. The therapist must cultivate an understanding of the relationship to see how this impasse came to be. What vulnerabilities or survival strategies have been activated and why they exist. Core impasses usually form when one partner is “feeling hurt or disappointed by a specific behavior pattern of the other” (Papp, Scheinkman, & Malpas, 2013). Subsequentially, once this exchange occurs, the other party will take a defensive posture. Though both parties played a role in forming these perceptions of the other, a critical mass is reached where the image formed is more powerful than the individual themselves (Papp, Scheinkman, & Malpas, 2013). Nate and Rachel most likely reached an impasse in their relationship very early on when Rachel was unfaithful to Nate while he was away for an extended period of time. Years of unresolved feelings and resentment have been allowed to build up and erode the foundation between the couple. Definitive molds were set and formed of each partner and in order to break these molds, a therapist may implement a few different types of interventions supported by Experiential Therapy. Role of the Therapist First and foremost, when a therapist is using Experiential Therapy, it is crucial that the therapist “be authentic and genuine” (Gehart, 2015). This requires a significant amount of work on the part of the therapist before practicing this type of therapy since it is vital that they not allow their own issues to leak into their client’s sessions. The therapist must have a strong moral fiber in the face of adversity as they push couples to unearth the uglier side of their relationship. The therapist must set boundaries and adhere to them, nudging the client’s towards accepting full 3

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The McDermott Family Intervention responsibility for their relationships and lives, without taking on the responsibility themselves (Gehart, 2015). If done properly, both the therapist and the client will grow from their interaction with one another. Neuroscience research has also been found to support this with proof that the more neuroplasticity a therapist has, the more likely their client is to experience success within the therapeutic process (Bailey, 2022). Much like embarking on a wilderness adventure, it is always better to have a guide that has traveled the path before. If the therapist is lost and unable to navigate these pathways in their own mind, they will not be able to lead the way for their clients to rewire their own neuropathways. Goals The first goal set for Nate and Rachel is a short-term goal of having less tension and arguing amongst themselves daily. In Experiential Family Therapy, the first step to doing this is to increase family cohesion. This is accomplished by increasing everyone’s sense of “belonging, being loved, being wanted, and loyalty” (Gehart, 2015) within the family. We also want to increase interpersonal boundaries, meaning everyone is allowed to be their truest selves, as well as increasing transgenerational boundaries, having autonomy in the nuclear family while still being able to connect with the extended family (Gehart, 2015). Intervention Application Affective confrontation of rigid patterns and roles is one of the interventions that could be implemented on Nate and Rachel. Affective confrontation can help to interrupt rigid patterns that the clients have formed, it can also shed light on areas where the clients may be contributing to the problems they are experiencing at that time (Gehart, 2015). Science supports this process by showing “the role of implicit memory, and mind which impacts human behavior and relationships” (Bailey, 2022). Implicit memory, when triggered, is not done consciously. This 4

The McDermott Family Intervention implies that using confrontation of rigid patterns may allow clients a reprieve from following pathways in their mind that automatically activate in specific situations. Since Rachel currently feels very strongly about Nate being the source of all their marital issues, this approach could greatly benefit the couple. The therapist could ask Rachel, “When did you decide to emotionally divorce your husband?”; or “At what point did you decide to live a separate life from your partner?”. The therapist could ask Nate, “Tell me when you decided to stop having fun with your spouse?”; or “When did work become your life partner?”. These questions are intended to shake the couple from their routine thought patterns. ‘Bringing the “taboo” topics out from the darkness and into the light would require the couple to confront the uncomfortable. Becoming aware may help the couple to make changes and form different interactions. This intervention can also promote personal growth (one of the goals in experiential therapy) by allowing the couple to take ownership over their lives and actions. Next, the therapist needs to assist Nate and Rachel in expanding their symbolic world. A wonderful way of doing this is through Sculpting. This intervention is particularly useful for a couple who is more on the analytical side. Sometimes, a couple’s intellect blocks change from occurring and “sculpting provides them with a way of connecting on an experiential level that circumvents their survival strategies and reveals their vulnerabilities” (Papp, Scheinkman, & Malpas, 2013). When using experiential therapy, the therapist often strives to do the unexpected, thereby forcing the couple from their ridged set of patterns. Breaking this cycle can often be done in a playful manor, or in ways that bring the couple out of their comfort zone. In this intervention, the therapist asks Nate and Rachel to close their eyes and think of their relationship in a fanciful way. How would they visualize the impasse they are experiencing? Once both parties have been able to formulate an image or analogy, the therapist takes turns asking each 5

The McDermott Family Intervention what they saw and how they would describe it. Often during sculpting, the therapist offers for the client sharing their image to place their partner in a position that demonstrates the image they saw in their mind. When recreating and acting out these scenes it allows the couple to move beyond their pre-established dialogue since there is no script in Sculpting. This exercise can challenge the couple “to communicate instead through symbolic and visual language” (Papp, Scheinkman, & Malpas, 2013). This may help Nate and Rachel reach beyond the molds they fit themselves into within the confines of their relationship. It would help each of them to have a better understanding of how their partner is feeling, and how they see themselves functioning within the confines they have constructed together in this impasse. With new shared images, the therapist can work with the couple to form new language and imagery for the future the couple would like to see. This will also help to achieve the goal of expanding the family’s symbolic world (Gehart, 2015). Sample Transcript: Therapist: “Rachel, tell me when you decided to emotionally divorce your husband?” Rachel: Looks offended and folds arms “I have Never decided that.” TH: “I’m seeing that question is bringing up feelings in you right now, would you like to share those with me?” R: “I just don’t see how this is relevant to anything going on currently. I mean, that happened so many years ago and I have gone through so many stages of trying to do everything perfectly in this relationship. I’ve tried to fill the “perfect wife” role. I’ve put myself in a box time and time again for him and his career. When he is emotionally distant from me, I become more and more independent and find my own love in friends. I don’t know what more he wants 6

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The McDermott Family Intervention from me when I’ve given all I can. And I think it’s entirely unfair to have blame placed on me for something I did YEARS ago at this point.” TH: “You said you feel as if you have tried to fill the “perfect wife” role. Does that mean doing all the things you just listed? Is that what makes a perfect wife” R: “I think that’s what he expects” TH: “How does it make you feel to always be inside of a box?” R: “I constantly feel like I can’t breathe.” TH: “What do you feel like Nate is doing while you are in that box? Does he help you step into it? Or do you get in all by yourself without any help from him?” R: “I feel like I put myself in here… but then he sits on the lid.” TH: “Can you show me using this space and your partner what this looks like?” Rachel gets up and proceeds to make herself small enough to fit under where Nate is seated TH: “What would it feel like if Nate wasn’t sitting on the lid anymore? How would that make your body feel?” R: “Like there was space for me to take a breath. I could ACTUALLY inhale all the way (takes a deep breath in) and my body could relax” ( breaths out) TH: Thanks Rachel for sharing and asks her to sit again to continue “Alright Nate, how did that make you feel? Was it uncomfortable to be sitting on top of your wife life that?” Nate: “Honestly, I hated it. It made me feel like she sees me as something that I’m not and every time I try to explain myself, I feel like she puts me back up on the shelf and tells me who and what I am.” TH: “Would you like to show me what that looks like when Rachel does that with you?” 7

The McDermott Family Intervention Nate gets up and moves Rachel into a position with her hand up to his face as if to say “Stop!”. He places himself in a position with hands to the side palms up with a confused/frustrated expression spreading across his face as he serves the scene himself TH: “How are you both feeling right now?” R: “Like we’ve been here before.” They are both looking at each other with some underlying frustration TH: “This posture feels familiar to you?” N: “Yeah” TH: “Rachel, what would happen if the fear of the box was gone? Would you be able to lower your hand when Nate tries to talk to you if you didn’t have to worry about not being able to breath?” R: Starts to lower hand and relax posture “Yeah… I don’t think I’ll feel like I’m fighting to save myself every time we talk” TH: “Nate, do you think you will feel more seen by Rachel if she is out of the box and not fighting you to stay out of it?” N: “Yeah… I think if she can trust that I’m not trying to put her in there in the first place… I think if she could hear me out, that might help.” Impact and Outcome During this session, the couple unearths some unspoken feelings they have towards each other. This will help the therapist in the future as they try to navigate the couple to calmer waters. Just from this one small exercise, the couple may find that some walls that have been built between them which can be easily traversed. Understanding the molds that they have formed 8

The McDermott Family Intervention within the context of their relationship can help this couple advance to an increased level of knowledge. Seeing their partner through the other person’s eyes, while using the Sculpting method, can really help this couple unblock and form new neuropathways about their relationship. This couple should be able to draw upon this experience in the future when experiencing disagreements, ensuring to not engage in the same patterns of behavior. Rachel can use her analogy of the box to remind Nate, and he can do the same with his sculpting her in the defensive mode. This gives the couple new tools and perspectives to work with, which will inevitably lead to different outcomes if used appropriately. The clients relaxing their body language over the course of this exercise is one indication that they were both leaning into the experiment. Agreeing to try to work with the other person’s picture in the future is a positive sign of growth and effectiveness of the assignment. From here, the couple will be able to have less tension between them, because neither will be bracing for the other to “place them in a box” or “put them on a shelf”. Saying the quiet part out loud, and allowing the other to know the root fear, will help strengthen their bond. In turn the couple should feel closer to each other and gain a deeper understanding of themselves in the process. Telehealth If one chooses to implement Experiential Therapy via telehealth, there will be a few challenges that will soon become evident. If exploring this case with Nate and Rachel virtually, the therapist would have to increase their verbal transparency ( Taylor, Springer, Bischoff, & Smith, 2021). Instead of relying on one’s ability to explain things physically in person, the therapist will have to use their words to give the couple a better understanding of how to conduct the interventions on their own. Asking more questions, giving more descriptions, being extremely aware of tone of voice ( Taylor, Springer, Bischoff, & Smith, 2021), are all things 9

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The McDermott Family Intervention which need to be allowed for when practicing Experiential Therapy via telehealth. The therapist would probably note that it takes longer for the couple to process things. Nate and Rachel, in person seeing a therapist, would be able to navigate the waves of emotions probably faster than they would over a computer screen, and this should be anticipated by the therapist. The exercise done, in this case, would have required significantly more effort by the therapist. They would have had to ask for details on how the couple had chosen to sculpt themselves during the exercise. Many additional clarifying questions would be needed for the therapist to gain the same amount of information that they were able to glean simply from being present with the couple in the same room. Summary In short, it is safe to say that Nate and Rachel could greatly benefit from working with a therapist while using experiential therapy. This style of therapy would allow the couple to achieve their goals, help strengthen their bond, and would encourages personal growth. The creative, playful, and often unexpected nature of Experiential Therapy is a wonderful way to help couples break molds of each other while stuck in an impasse. 10

The McDermott Family Intervention Reference: Bailey, M. E., PhD. (2022). Science catching up: Experiential family therapy and neuroscience. Journal of Marital and Family Therapy, 48 (4), 1095-1110. https://doi.org/10.1111/jmft.12582 Gehart, D. R. (2015). Theory and treatment planning in family therapy: A competency-based approach. Cengage Learning. Papp, P., Scheinkman, M., & Malpas, J. (2013). Breaking the mold: Sculpting impasses in couples' therapy . Family Process, 52 (1), 33–45. Taylor, N. C., Springer, P. R., Bischoff, R. J., & Smith, J. P. (2021). Experiential family therapy interventions delivered via telemental health: A qualitative implementation study. Journal of Marital and Family Therapy, Suppl.Special Issue, 47 (2), 455-472. https://doi.org/10.1111/jmft.12520 11

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