Neuroscience and Clinical Practice

Dr. Robert J. MacFadden

Relational Empowerment (Fishbane)

Insights from “Facilitating relational empowerment in couple therapy”,
written by Mona DeKoven Fishbane and appearing in Family Process, Vol. 50, No 3, 2011, 337-352. Excerpts below are taken directly from this source with page numbers included.

Power in couples can be looked at in three ways: Power over (involves competition, individualism, partriarchy); Power To (ability to self-regulate, to read and manage own emotions and have voice and respect others’ voice); and Power With (couple’s commitment to co-nurture the relationship through empathy, respect, generosity). ABSTRACT, p. 337

Couples resort to a variety of tactics to connect with each other and end up alienating each other.
Power Over. Involves cultural values, hierarchies… Underlying many Power Over interactions is a deep desire to be heard, understood and affirmed. P. 342

Couple therapy can help to facilitate relational empowerment which involves the ability to navigate and regulate one’s inner world (Power To) and to interact successfully with respect and generosity with the partner and form more egalitarian relationships which heightens couple satisfaction(Power With). Increases mastery and hope. P. 339.

Emotional reactivity is hardwired into the brain, especially when threat perceived. Each set each other off through emotional contagion. When the amygdala is highly aroused this shuts down the pre-frontal cortex. Later on the partners often create a narrative which blames the partner and exonerates the self. P. 340

Rather than “I think therefore I am”, it may be more “I feel therefore I am (Cacioppo & Patrick, 2008)”. The brain itself is embodied with a constant body/brain feedback loop. Being aware and regulating one’s own emotions is crucial for relational empowerment” and for empathy in particular. Self-attunement and empathy with others may utilize the same resonance circuits in the brain (Siegel, 2007, 2010). P. 340

Relational empowerment moves from two victims to two co-authors of the relationship. Shared sense of relational responsibility. Challenges automatic reactivity, justifications and blame to develop new skills. P 342

Power Over Dynamics

Physical violence, threats, intimidation
Humiliation, contempt
Power struggle, domination
Disregard, blame

Power To Skills

Flexibility, thoughtfulness, reflection
Self-responsibility, responsiveness
Emotion regulation, self-soothing
Differentiation of self, boundaries
Making a relational claim
Respectful conflict

Power With Skills

Shared relational responsibility
Nurturing the ‘we’
Respect, accepting differences
Care, generosity
Repair, apology

Contents from Table 1, page 342.

Regulating emotions does not mean suppressing emotion with reason, but rather experiencing emotions without becoming overwhelmed. Identifying and naming emotions activates the prefrontal cortex and calms down the emotional brain (Creswell, Way, Eisenberger & Lieberman, 2007). With emotions managed, one can feel safer connecting to self and other. P. 343

Imagery techniques can be helpful- therapist might have the partners imagine their prefrontal cortex calming their rowdy amygdala. Neuroeducation. P. 344

As partners feel more confident about their own emotional regulation, they become less desperate for the other’s capacity to soothe them. P. 344

If one has Power To, one does not become dysregulated but is calm enough to address the issue with the partner. Mindfulness meditation and focused breathing and journaling can help with self-regulation. P. 344
Important to differentiate oneself from one’s partner. Envisage a fence between their “yards”. Enjoy one’s own yard. Can be more compassionate of other because self is not responsible for other. Can challenge the partner more when yard violated. P. 345

Make an emotional claim, to speak one’s own feelings and needs in a manner that also holds concern for the other and the relationship. Challenging gender-based assumptions is an example of this. Not dominate or be dominated. P. 345

Stonewalling feels like abandonment. Need to turn towards the other. Take a time out, a breather to regain emotional control. P. 346

Power With

Empathy key aspect of Power With. Mutual empathy helps partners feel secure and connected (attached) as well as validated.

Empathy involves several neurobiological components:

Resonance: a subcortical automatic process in which one feels in one’s body/brain what the other feels;

Cognitive empathy where one consciously puts oneself into the other’s shoes;

Self-regulation and a boundary between self and the other, so one does not become overwhelmed in the face of the other’s pain.

Empathy releases Oxytocin which reduces the stress hormone cortisol. With motivation both men and women can increase their level of empathic accuracy. P. 347.

Empathy can be framed as a set of skills and learned. Blocked by defensiveness, blame and guilt.

Need to take joint responsibility for care and repair in the relationship.

All relationships involve breaks in connection, cycles of connection, disconnection and repair. Even in well attuned mother-child relationships it is estimated that 70% of communication is not in synchrony (Tronick, 2007, p. 159). Fishbane, p. 349.

Therapist need to have Power To or capacity for self-regulation that allow for a safe entry into the couple’s limbic world without being overwhelmed. Therapists needs also Power With to feel feeply with clients and to join them in their limbic experience. P. 350