CC12 Workshop 14 – Focusing on Deficits in Couple Therapy: The PACT® Methodology – Stan Tatkin, PsyD

Description:

Deficits such as affect blindness, alexithymia, and poor theory of mind will likely lead to mutual dysregulation in couples during periods of distress or threat and is the driving force behind relationship dissatisfaction and dissolution. This workshop will introduce attendees to the most common social-emotional deficits and will demonstrate how to identify these deficits and what to do about them in couple therapy.

Educational Objectives:

1. Write and describe at least four social-emotional deficits commonly found in couple therapy.
2. Apply at least one intervention for dealing with each deficit.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

Neuroscience in Relationships

• Neuroscience revitalizes old theories; facial expressions and movement are key cues.

• “Marriage monster” and “commitment monster” described—how partners change in relationships.

• Brains are wired for threat, not love; negative memories stick more easily.

Repair and Memory

• Quick repair is crucial to avoid lasting emotional damage.

• Hyperarousal resets in ~20–30 minutes (Kiko Glazer).

• Chronic stress leads to "allostatic load"—wear and tear on the body.

Attachment Styles

• Secure: predictable, collaborative.

• Insecure-organized: self-focused, fear-driven.

• Avoidant: prefers solitude, self-regulates, may use passive aggression.

• Gaslighting used to manipulate and control.

Interactive vs. Auto-Regulation

• Interactive regulation: mutual eye contact, empathy, co-regulation.

• Self-regulation challenges tied to childhood pressures and trauma.

• Orbitofrontal cortex and insula critical to empathy and connection.

Deficits vs. Defenses

• Deficits = inability (e.g., alexithymia, poor theory of mind).

• Defenses = protective strategies.

• Therapists must distinguish the two to avoid shame and misinterpretation.

Visual and Emotional Cues

• Many partners miss micro expressions or visual signals (e.g., pupil dilation).

• Failure to notice cues leads to loneliness, disconnection.

• "Affect blindness" impairs emotional connection.

Examples and Case Dynamics

• Couples with one partner lacking theory of mind feel isolated.

• Deficits often mistaken for indifference or malice.

• Importance of education, normalization, and proper referrals.

Therapeutic Techniques

• Use micro expression training, frame analysis, and observation.

• Emotional regulation and therapist patience are key.

• Strategies should target both communication and structural issues.

Structural Challenges

• Issues like infidelity and trust must be addressed systemically.

• Memory deficits (e.g., from injury) affect connection—testing advised.

Therapist’s Role

• Act as advocate for both partners.

• Help regulate emotions and provide stability.

• Support couples in navigating deficits and emotional challenges.

Q&A and Conclusion

• Questions covered deficits, emotional regulation, and therapy strategies.

• Emphasis on therapist education and skill development.

• Final thoughts: understanding deficits is essential to effective couples therap.