I’m always interested in new ways to look at relationship issues. ACT has been around as an individual mode of therapy for a while. Now Acceptance and Commitment Therapy is also a fascinating new approach to couples therapy.
Avigail Lev, PsyD. and Matthew McKay Ph.D. has formulated an approach to couples therapy that connects the notion of “schemas” which are the architecture of conflict, to the ACT Therapy Protocols.
ACT employs interventions that focus on acceptance and emotional exposure. The clinical goal is to increase resilience and tolerance to stress and uncover shared values that may be recruited as an adaptive alternative to avoidance and withdrawal.
Relationship issues are called schemas in ACT. Our minds are wired to make meaning out of connecting events as we move through time. “Schemas” are the stories we tell ourselves about our self and relationships (McKay & Fanning, 1991). They are a neural net of relational frames that comprise the sum of our fears, aspirations, and expectations across the gamut of human interactions. We predict behavior on the basis of schemas.
The problem with schemas in a nutshell, is that they are our own B.S. We make it all up.
There is a strong thread of similarity that flows from ancient Stoic Philosophy, through Cognitive Behavioral Therapy, and finally to ACT. These 10 schemas create “issues” which plague couples who are mired down by these pesky schemas.
Abandonment/Instability Schema. Spouses who hold this belief are waiting to be abandoned by their spouses. On the milder end of the spectrum we might expect to see varying degrees of Anxious Attachment, however, this fear of abandonment issue can also find expression in Borderline Personality Disorder. Relationship issues for these unfortunate souls are that often pair up with a cold and aloof partner who expresses a narcissistic sense of entitlement, or a Subjugation Schema.
Mistrust/Abuse Schema. Spouses with this schema have relationship issues with trust. They believe that intimate others are perfectly capable of deliberately harming or exploiting them. Spouses with these relational issues will be suspicious of their partner’s motives. Paradoxically these spouses attract mates who are often either untrustworthy or narcissistic. Common relationship issues include a mate with either Failure Schema, a Defectiveness/Shame Schema, or a self-negating Self-Sacrifice/Subjugation Schema.
Emotional Deprivation Schema. These folks have relationship issues which stem from their belief that their partner will never be able to provide the support and validation that they require.
These spouses are often lonely and feel that there is something missing from their intimate relationship. consequently, they tend to attract partners who are cool and detached.
Common partner schemas here are perhaps an Entitlement/Grandiosity Schema, a Subjugation Schema, or a maybe a Defectiveness/Shame Schema.
Defectiveness/Shame Schema. Imagine a relationship issue where you hold the fundamental belief that you are inherently unlovable. That there is something wrong with you, or that you are incredibly defective in some major ways.
These people feel that their core selves are fundamentally unlovable, and they fear being recognized as such. This is a common schema for Developmental Trauma.
These folks gravitate to partners who are harsh and critical, a Mistrust/Abuse Schema, or an Emotional Deprivation Schema.
Social Isolation/Alienation Schema. These people have the relationship issues that result in feeling different, awkward, and not fitting in well in social situations. They enter relationships with Defectiveness/Shame Schema, or an Emotional Deprivation Schema or even a Mistrust/Abuse Schema, validation of perspectives will be a Perpetual Problem for these couples.
Dependence Schema. These spouses are super-dependent on their partners. They just know that they could NEVER make it on their own. These folks freeze up, finding little trust in their own thoughts or feelings. Feedback from others is a food group. They prefer spouses that “take charge.” Relationship issues usually stem from either an Entitlement/Grandiosity Schema or an Unrelenting Standards Schema.
Entitlement/Grandiosity Schema. Terry Real’s thinking on these relationship issues has been very persuasive. The main relationship issue with narcissism is that the spouse feels consumed or cornered by the intimate relationship and its attendant boundaries and mutual
obligations. The grandiose want to live for themselves. Terry goes right at it asking, in your family, who did you see do it to who? And/or who did it to you?” The grandiose feel special.
They prefer a partner who can notice that. Relationship issues are best teased out with a Self-Sacrifice/Subjugation Schema, Emotional Deprivation Schema Defectiveness/Shame Schema, or maybe a Defectiveness/Shame Schema.
Self-Sacrifice/Subjugation Schema. There is a key difference between the Self-Sacrifice and Subjugation schemas. Those spouses who are in a subjugation schema surrender their will out of fear. They feel they are under the direct control of their spouse. The Self-Sacrifice
schema is characterized by a hyper-focus on pleasing others and gratifying their needs before your own. Relationship issues flow from their attraction to partners with Entitlement/Grandiosity Schema, Abandonment/Instability Schema or Emotional Deprivation Schema.
And finally, the Unrelenting Standards Schema. These spouses set high standards for themselves and others. Rarely satisfied, they believe perfection is not only attainable, it’s an obligation to get there. Of course, it
logically follows that spouses with persistently high standards would tend to marry partners who are particularly inept at meeting the standard such as a Defectiveness/Shame Schema, or Failure Schema.
ACT Couples Therapy
I like the fact that schemas may be revealed in a formal assessment process. These is an online Schema Questionaire for use with the ACT Model. The point of the therapy is to begin to explore each partner’s schema, map out the triggers, and validate the wounding primary pain.
The next step is to identify the SCB’S (Schema Coping Behaviors). Example of SCB’s; attacking, blaming, controlling, insisting, silence, disconnection, defending, passive-aggressive behavior etc.
SCB’s are relational strategies recruited to block schema pain. SCB’s are experiential avoidance behaviors. The ACT therapist does some psycho-education on schema and then identifies the particular schema that the client couple present. The therapist then provides a formulation of the cycle (sound familiar?) to the client couple.
Daniel is a Marriage and Family Therapist. He currently sees couples at Couples Therapy Inc. in Boston, Massachusetts, three seasons in Cummington (at the foothills of the Berkshires...) and in Miami during joint retreats with his wife, Dr. Kathy McMahon. He uses EFT, Gottman Method, Solution-focused and the Developmental Model in his approaches.
We schedule three double sessions with you in total. You complete an extensive online relationship questionnaire. In that final meeting, we spend almost two hours with you explaining, from a science perspective what's working in your relationship, what's not, and how to fix it.
It's all done online, either week-by-week or over a weekend.