Psychobiological Approach to Couples Therapy

Psychobiological Approach to Couples Therapy

The Psychobiological Approach to Couples Therapy® (PACT) relies on the application of research in neuroscience and attachment theory to improve interactions between couples. This approach, which was developed by Stan Tatkin, aims to help couples notice their reactions as they occur and learn how to better address one another's attachment needs.

Couples seeking professional help to address relationship issues and/or develop or strengthen a long-term relationship may find PACT a helpful approach. 

History and Development

Stan Tatkin, a researcher, clinician, and teacher, created PACT specifically for work with couples. PACT is similar to other attachment-focused approaches such as emotionally focused couples therapy but relies on research on four different topics, which are referred to as the domains of PACT:

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  1. Arousal regulation: The way the human mind and body respond to and manage moods and emotions—both their own and their partner's—such as stress, anger, or affection
  2. Attachment theory: This theory helps explain how people come to form and nurture attachments with significant people in their lives. 
  3. Developmental neuroscience: How the brain changes over time in response to both environmental and biological inputs and the impact these changes have on relationship behavior, from infancy to adulthood.

The PACT Institute, developed by Tatkin and his wife, Tracey Boldemann-Tatkin, serves as a hub of education about the approach and offers training to therapists interested in incorporating PACT into their own practices. The Tatkins also hold several annual couples retreats. 

Principles of PACT

According to Tatkin, understanding the human need for connection can help couples form more secure attachments and deepen their existing attachments by developing secure-functioning relationships based on mutuality, sensitivity, collaboration, and fairness. To this end, he proposes a set of principles: 

  • Creating a "couple bubble" allows partners to keep each other safe and secure. 
  • Partners can "make love and avoid war" when the security-seeking parts of the brain are put at ease.

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  • Partners who are experts on one another know how to please and soothe each other.
  • Partners should prevent each other from being a third wheel when relating to outsiders. 
  • Partners who want to stay together must learn to fight well.
  • Partners can minimize each other’s stress and optimize each other’s health.

Early relationships affect each person’s attachment style, and this attachment style tends to persist in adult relationships. PACT endeavors to help couples create secure attachments within the relationship and to address the effects of attachment threats. Jealousy, for example, can threaten an attachment relationship and may also spur specific physiological reactions that therapists can address in treatment sessions. 

Tatkin suggests that better management of arousal—including fear and distress—in the moment can help couples understand one another and work through conflict, which can undermine the ability of one partner to understand the other, or even to correctly remember the source of the conflict. 

He also emphasizes that repetitive physiological reactions, such as the fight-or-flight response, can undermine communication and trust, and PACT treatment focuses on noticing and understanding these in-the-moment responses. 

How Does PACT Work? 

PACT sessions promote focused attention to micro-expressions and other details of interactions that may be nearly imperceptible. The therapist helps recreate experiences that cause trouble in the relationship, such as controversial conversation topics or emotions that tend to provoke problematic reactions. As the couple engages, the therapist encourages each partner to notice subtle shifts in voice, body language, and facial expressions. In some cases, the therapist may videotape the couple to offer immediate feedback. 

PACT sessions can be lengthy—as long as 3-6 hours. But this approach also consists of fewer sessions than more traditional approaches to couples counseling. Building on the idea that couples don’t always know why they emotionally react the way they do, Tatkin’s approach focuses on addressing the underlying emotions and behaviors rather than attempting to resolve any one specific relationship problem. By strengthening a couple’s attachment and helping them control their stress-induced reactions, PACT can often help partners better manage conflict in the future. 

Training and Certification 

The PACT Institute offers three levels of training for clinicians. Though each level of training lasts only a few days, the entire sequence is designed to last three years. Students who complete all three levels can become certified providers of PACT. 

The PACT core faculty teaches Level I courses to beginners, but Tatkin teaches Levels II and III. Level I and Level II training sessions blend exercises, clinical presentations, case reviews, and case enactments with lectures and group discussion. Practitioners pursuing Level III training are required to complete two 3-day sessions with Tatkin after completing Levels I and II, complete a practicum, and submit a final case analysis and video.

How Can PACT Help?

PACT is a form of couples therapy and as such is not designed to treat individual issues such as depression, anxiety, or PTSD on an individual level. However, PACT can address the ways in which a range of issues might have an impact on a couple’s relationship.

Rather than targeting specific relationship issues, PACT addresses the ways that attachment styles and psychobiological makeup can affect interactions. Feelings of intense anger in one partner can trigger fear in the other partner, for example, and may influence behavior. Even as concerns—and the stories couples tell themselves about those concerns—change over time, the emotional reactions may persist. PACT addresses the emotions, the subtle behaviors they trigger, the physiological experiences they engender, and the resulting effects on the relationship, teaching the couple how to observe and understand these specific biological patterns. 

Concerns and Limitations

Like many other forms of couples therapy, PACT was designed for use with couples who have formed a primary attachment to one another. People in nontraditional relationships—such as non-monogamous partnerships or polyamorous triads—may not find PACT to be as helpful as those in traditional relationships. PACT assumes couples form a romantic attachment to one another and prioritize this attachment. Couples who do not see the relationship as a primary attachment, or who do not want such a relationship, may not benefit from PACT. 

PACT is a new approach to therapy, so it has not yet undergone rigorous scientific testing. Most of the existing research about PACT has been published by Tatkin himself. However, many of the theories upon which PACT builds, including attachment theory, are the subject of decades of research.

References:

  1. Tatkin, S. (2016). Wired for dating: How understanding neurobiology and attachment style can help you find your ideal mate. Oakland, CA: New Harbinger.
  2. Tatkin, S. (2012). Wired for love: How understanding your partner's brain can help you defuse conflicts and spark intimacy. Oakland, CA: New Harbinger.
  3. Solomon, M., & Tatkin, S. (2010). Love and war in intimate relationships: connection, disconnection, and mutual regulation in couple therapy. New York, NY: W. W. Norton.
  4. Tatkin, S. (2004). A developmental psychobiological approach to therapy. Psychologist-Psychoanalyst: Division 39 of the American Psychological Association, 23(No. 4), 20-22.
  5. Tatkin, S. (2009). A psychobiological approach to couple therapy: Integrating attachment and personality theory as interchangeable structural components. Psychologist-Psychoanalyst: Division 39 of the American Psychological Association, 29(3), 7-15

 

Last updated: 02-16-2017

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