Couples

EMDR for Couples—Deciding Where to Start 

By
Mary Ray, LCSW

Couples are complicated.  And when each partner has their own trauma history, it can be even more complex. They each have their own histories, and then there’s the history of the couple.  So, of course, they trigger each other. And much of why it happens is out of their awareness, so day-to-day problems become huge obstacles to communication and intimacy. These factors make offering interventions that serve both partners individually as well as the couple a real challenge.  

Assessing Stability and Capacity  

When I’m deciding where, when and how to start EMDR with a couple, I consider three factors: 

First, I assess the stability of the relationship by asking questions like these: 

  • Do they have the same goals for therapy?  
  • Have they listed one another as their emergency contact?  
  • Are they comfortable sitting in each other’s presence? 
  • Do they look one another in the eye when listening and speaking? 
  • Do they listen and respond thoughtfully? 
  • Are they able to let each other finish talking before responding?  
  • Can each partner take responsibility for their behavior—as opposed to blaming the other? 
  • Can each partner own their own part in communication breakdowns?  

Then I explore the capacities of each partner:  

  • Can each partner see the part they play in their problematic interactions?  
  • Can each see the past-present connection in their current behavior with their partner? 
  • Can each partner maintain dual awareness and shift states in the “safe place” exercise?   
  • Do they affirm their commitment to one another in both joint and individual sessions? 

 
Finally—and this is critical—no couple is ready for EMDR when there are secrets, different goals for therapy, ongoing affairs, addictions or serious dissociative disorders. 

Once you have a sense of each partner’s goals for therapy, the commitment they each have to one other, the marriage and each partner’s capacity for memory reprocessing, you can decide how to proceed. Let’s look at two couples who benefitted from different approaches based on their answers to these questions.  

Sid & Carol  

Their Stories.

When Sid and Carol lost their 19 year-old son to cancer, Sid reacted by working long hours. Left alone in the evenings, Carol felt panicked and called Sid every 15 minutes. Sid was annoyed with Carol and every night they repeated this cycle.  

In a joint session, we explored what, in their current situation, reminded them of childhood using a Floatback. We learned that Carol’s single mom worked nights and was not available—even by phone. Six year-old Carol took care of her four year-old brother and felt alone and terrified every night. 

When Sid was seven, his mother died and his father reacted to the loss with frequent bouts of anger. In order to avoid his father’s wrath, Sid went to school at 7 am every morning and studied until school began. After school, Sid did odd jobs and didn’t return home until his dad was asleep.  

As we explored the past-present connections, each partner realized that they were reacting to one another in the present the same way they had reacted in their families as children. But each of them needed assistance in maintaining dual awareness when going back to the past. Overall, the work was painful and difficult for both of them.  

Deciding Where to Start.

Both Sid and Carol gave mixed answers to the assessment questions. While they affirmed their commitment to one another and their relationship, each partner listed someone else as their emergency contact which signaled a crack in the foundation of their relationship. That instability, their early trauma histories and their difficulty maintaining dual awareness led me to recommended that each partner begin with individual EMDR reprocessing work with me separately.  

The Work.

In individual sessions, we began by desensitizing current triggers and reprocessing some childhood traumas. Then we used joint sessions—both partners with me—to integrate changes from their individual EMDR work into their relationship dynamic. Individual EMDR sessions alternating with joint sessions helped reestablish and strengthen a base of security and trust in the relationship and provided the foundation for additional change. 

Their Progress.

In joint sessions, Sid and Carol now make more eye contact when they speak and listen. They’ve improved in letting one another finish before speaking themselves. They report feeling increasingly safe with one another at home. And when updating their treatment plans, they listed one another as emergency contacts. As therapy continues, they increasingly implement flexible ways of handling day-to-day challenges at home and to demonstrate increased capacity in supporting one another in their grief work. This progress is possible because they were able to strengthen their own capacities and resolve some early trauma in their individual work. 

Ted & Nancy  

Their Stories.

Ted worked extremely long hours as a hospital administrator. He had little energy left when he finally got home. Nancy reported waiting for Ted to help put the kids to bed. As it grew later and later, Nancy’s hope turned to hurt and anger. So when Ted did get home, Nancy peppered him with demands. Ted, overwhelmed by the input, retreated to his study. This was their nightly drama.  

Ted was the youngest of four and described himself as the lonely, invisible child, who did not matter to his family. Nancy was the eldest of five children. Her nightly responsibilities included several chores and getting her siblings to bed before she could start her homework. She felt she was alone growing up.   

Deciding Where to Start.

Both partners recognized that they were responding in the present the same way they had reacted to their traumatic childhood experiences. They recognized how their own behavior was triggering their spouse. Both Ted and Nancy could each maintain dual awareness and effectively shift states. As for their relationship—they looked each other in the eye when speaking and waited for one another to finish before talking. Each maintained their commitment to one another and to their relationship. They listed each other as emergency contacts. Based on the strength of their relationship and their capacities for reprocessing, I agreed when Ted and Nancy asked to support each other in their individual work.    

Here’s How the Process of Partners Supporting Each Other Works.

“Support” means that one partner is present and privy to everything in session, while the other partner is reprocessing. Supporting each other in this way strengthens understanding between partners. And it strengthened their ability and resolve to make proactive changes to their own behaviors. In Ted and Nancy’s case, they made practical choices to maintain their new level of closeness and intimacy. Ted hired an assistant and was able to be home earlier to help.  Nancy hired a local teen to assist her in the evening hours before Ted returned home. They continue to work on current triggers as well as future templates in order to move forward together in positive patterns of interaction.  

There are real benefits to doing Individual EMDR with a partner present. It can create a strong sense of empathy between partners. Being able to assist helps each partner feel safer, connected and purposeful. And changes from the EMDR reprocessing can be integrated at the end of an individual session. Not all couples are ready for this approach.  
 
I hope you’ll try out the assessment questions to find out where a couple’s relationship stands and what the capacities of the partners are at the start of therapy. Their answers can help you begin in a way that best serves both partners individually and the couple as a whole.