Couples Therapy
Specialty
Couple Therapy
Beyond Communication
Trauma, Your Nervous System, and Gottman Principles Intersect in Couple Therapy
Relationship challenges are common; couples often seek therapy to improve communication or resolve specific conflicts. While essential, sometimes difficulties run deeper, rooted in past experiences, individual histories, and how our bodies respond to stress and perceived conflicts in relationships and daily life. A comprehensive approach to couple therapy addresses what happens between partners and individual partners’ internal experiences. I integrate insights from established frameworks, such as the Gottman Method, Polyvagal Theory, and EMDR Therapy, to help couples heal the attachment injuries, and build resilient, fulfilling relationships.
“Love isn’t a state of perfect caring. It is an active noun, like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now.”
~ Fred Rogers
The Gottman Method
Assessing the Relationship
The Gottman Method is a highly respected approach to couple therapy, often beginning with an assessment process including conjoint and individual sessions, plus questionnaires. It focuses on strengthening relationships in three core areas: building friendship, managing conflict, and creating shared meaning. Based on decades of research, the Gottman Method provides practical tools to help couples disarm conflict, increase intimacy, improve communication, and replace negative patterns with positive interactions. It allows couples to navigate even persistent challenges, which Dr. John Gottman notes makeup about 69% of marital conflicts (Gottman, 1999).
However, sometimes partners find it difficult to consistently apply communication or conflict resolution skills, especially when intense emotions or defensiveness hijack interactions. This is where understanding the underlying physiological response comes in.
Polyvagal Theory
The Nervous System’s Role in Connection and Safety
Polyvagal Theory, developed by Stephen W. Porges, PhD, offers a powerful lens for understanding how our autonomic nervous system (ANS) dictates our capacity for connection and feeling safe. It describes a nervous system that evolved through distinct stages, leading to three primary response states:
- Immobilization: The most primitive state, associated with shutdown or feeling frozen, is linked to the unmyelinated vagus nerve.
- Mobilization: The familiar “fight or flight” state, driven by the sympathetic nervous system.
- Social Engagement: A uniquely mammalian system involving the myelinated vagus nerve, supporting connection, facial expression, vocal tone, and the capacity to feel safe in relationships.
Our nervous system constantly assesses risk in the environment through a process called neuroception. Based on this subconscious assessment, it shifts between these states. Crucially, our physiological state limits our range of behavior and psychological experience. When we feel safe, our Social Engagement System is active, allowing for connection and calm. But under perceived threat (even subtle cues), our nervous system defaults to more primitive defense states – fight, flight, or shutdown.
In the couple’s therapy, the persistent challenge that makes up about 69% of marital conflicts (according to Dr. John Gottman) can feel as if a chronic threat to our nervous system to react the same way to our significant other, causing the couple’s interaction to become gridlocked.
Trauma, including relational trauma and dysfunctional family-of-origin patterns, can result in individuals or couples becoming ‘stuck’ in defensive states, making it hard to access the regulated state needed for healthy social engagement, communication, and connection – precisely the skills the Gottman Method aims to build. However, understanding this physiological underpinning can bring relief, as it helps us understand why we react defensively, often mimicking evolutionary responses in reverse (dissolution).
“Marriage is not a love affair. A love affair is a totally different thing. A marriage is a commitment to that which you are. That person is literally your other half. And you and the other are one. A love affair isn’t that. That is a relationship for pleasure, and when it gets to be unpleasurable, it’s off. But a marriage is a life commitment, and a life commitment means the prime concern of your life. If marriage is not the prime concern, you’re not married…”
~ Joseph Campbell
EMDR Therapy
Processing the Roots of Reactivity
Eye Movement Desensitization and Reprocessing (EMDR) therapy is a scientifically supported treatment for trauma and other mental health symptoms. It is based on the Adaptive Information Processing (AIP) model. This model suggests that when traumatic or highly distressing experiences occur, the brain’s natural information processing system can get disrupted, leaving memories unprocessed or “stuck.” These unprocessed memories, containing the original negative emotions, beliefs, and physical sensations, are thought to be the basis for current symptoms and problematic behaviors.
EMDR therapy uses structured protocols, often involving bilateral stimulation (like eye movements), to help the brain reprocess these distressing memories. This facilitates their adaptive resolution and integration. EMDR has shown effectiveness in treating PTSD, anxiety, depression, prolonged grief, and obsessive symptoms, among others. It can reduce distressing symptoms like nightmares and flashbacks and address bodily sensations associated with trauma. Research even suggests it may have protective effects on brain structure under stress.
In the context of couple therapy, EMDR can be invaluable. Dysfunctional relationship patterns can be reenactments of earlier relational traumas from the family of origin. EMDR can effectively transform these earlier traumas, leading to less reactivity, greater distress tolerance, and more resilience. Furthermore, couples may experience shared traumatic events within their relationship, such as infidelity, conflict, or loss.
Integrating These Powerful Approaches for Couple Healing
My integrated approach recognizes that relationship issues are often complex, involving not just changing the interaction between the partners but also deeply ingrained physiological and psychological responses to past and present relational trauma.
Gottman Method for Assessment
I follow the Gottman Method by understanding the history of relationships, from when you first met to where you are now. When you see a doctor, the doctor often asks about your health history. As a couple’s therapist, the couple’s relationship has a history. I invited the partners to share with me from the time of their first impression of each other, their transition and decision to become a couple, significant events (such as buying a house, career change, or loss of a parent) in the couple’s history, unresolved conflicts, and the reasons for therapy. After the couple’s history sessions, I scheduled individual appointments with each partner, if needed. A person is more than just a partner. In the personal session, I get to know each partner, their likes, interests, work, extended family, childhood experiences, and mental health issues.
Understanding the “Why” with Polyvagal Theory
I use Polyvagal Theory to help couples understand their own and their partner’s defensive reactions not as willful defiance but as automatic, wired-in responses of a nervous system perceiving threat. I also assist couples in paying attention to personal autonomic nervous system responses and establishing an understanding of “triggers” and “glimmers” in the relationship. Awareness of their autonomic states helps partners recognize when they are in a state that makes connection difficult. This can also foster compassion and reduce blame.
Healing the Roots with EMDR
Through EMDR, we can target and reprocess the unprocessed traumatic memories – both individual childhood/past traumas that impact current reactivity and shared distressing experiences within the relationship. By processing these memories, the intensity of the emotional and physical responses decreases, helping to “retune” the nervous system away from chronic defense states toward regulation and safety. The AIP model suggests that resolving these traumatic memories will decrease symptoms and improve relationships. The EMDR Couple Protocol, which involves partners processing shared events with simultaneous bilateral stimulation, is specifically designed to enhance relationship satisfaction, depression, and anxiety by processing these mutual wounds.
As the nervous system becomes less reactive and more regulated through EMDR processing, partners become more available for connection, creating a foundation for practicing new communication and conflict management skills and shared desires and goals. The capacity for empathy, understanding, and intimacy increases as the automatic threat responses diminish.
My Goals
Goal # 1 :
Change the couple’s interaction from unconscious reactions to conscious responses.
Goal # 2:
Facilitate personal growth with awareness of individual physical, emotional, and behavioral experiences to have more freedom to make choices.
Couple's therapy requires a very delicate balance of my collaboration with each partner to benefit the relationship. I often described that "relationship" is our primary clients and the three of us work together for the better good of the relationship. To balance my relationship with each partner, I do NOT mix and match couple and individual therapy.
That is, I do not see a client for individual therapy and change it into couple therapy. It makes the partner who joins later as "the third person" in my relationship with the first partner. I also do not see a couple for therapy and change it to individual therapy with one of the partners. I can see partners individually during the couple therapy process, but all information will be shared in the couple therapy sessions.
As "trust" and "commitment" are the four walls in the couple relationship, there are two implications in our work together. I will not keep the secret from one partner to the other. If you tell me something individually, I will encourage you to share them with your partner on your own in our next session. If you are currently in the infidelity situation and haven't cut off or can't decide whether you can cut off that relationship or not, I am unable to work with you. If you plan to use the insurance, please note that the insurance company reimburses "medical issues" as it is "medical insurance." Therefore, the insurance company only reimburses the clients with mental health issues fulfilled a psychiatric diagnosis.
For couples who seek couple therapy, "we don't get along" or "we fights" is not a medical issue. "We don't get along, and that made me depressed," and your depressive symptoms fulfilled the medical diagnosis that is the medical issue.
There are two implications of the medical necessity to the couple's therapy. First, one of the partners needs to have a mental health diagnosis. Try to think about this as going to your doctor's appointment. Your doctors will assess what brings you to the visit and give you a diagnosis for your insurance company. Like physical health, I assess the clients' mental health conditions based on their self-report assessment before the intake and based on my observation and communication in the sessions. I make the diagnosis based on these two sources and assess how the mental health issues play out in the couple's relationship/interaction.
The second implication is that at least one of the partners will carry a mental health diagnosis.
Currently, I do NOT practice the medical model of couple's therapy. I work with couples with their relationship issues. For couples with one or both partners with mental health issues, I prefer to work with the partner with mental health issues INDIVIDUALLY.
(“No Surprise” Act)
In January 2022, Congress passed the “No Surprises” Act that obliges health care providers—including mental health providers—to furnish clients who self-pay with a “good faith estimate” of the cost they might expect to incur in the calendar year. (Link to “no surprise act” is here)
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
Your own cost will be number of visits you schedule multiplied by my fee. Currently, my standard fee is $180/hr for the initial assessment and $160/hr for the ongoing sessions. An hour session is generally 50-60 minutes. Some clients might request longer session, such as for the couple’s therapy or EMDR therapy. How many visits you can expect is variable, difficult to anticipate, and ultimately, up to you. I will provide existing clients with a good faith estimate based on a range of number of sessions in the calendar year.
Contact Dr. Chen
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Address
12 Essex St. STE 8, Andover, MA
Phone
978-482-7480
