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226: Childhood Trauma & Relationships with Lisa Ferentz

Welcome back to The Couples Therapist Couch! This podcast is about the practice of Couples Therapy. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

In this episode, Shane discusses childhood trauma & relationships with Lisa Ferentz. Listen to the episode on Apple Podcasts, Spotify, and your other favorite podcast spots, and watch it on YouTube – follow and leave a 5-star review.

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  • Show Notes
  • The Couples Therapist Couch Summary
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The Couples Therapist Couch 226: Childhood Trauma & Relationships with Lisa Ferentz

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In this episode, Shane talks with Lisa Ferentz about childhood trauma & relationships. Lisa is the Founder of The Ferentz Institute and a recognized expert in the strengths-based, de-pathologized treatment of trauma. She’s been in private practice for over 40 years. Hear the huge role caretakers can play in trauma, the impact of shaming, why maintaining curiosity is so important as a therapist, how to pinpoint neglect, and why couples therapy work also means individual work. This episode covers everything from childhood trauma to couples therapy. Here’s a small sample of what you will hear in this episode:

  • What is trauma?
  • How does shame compare to guilt?
  • What role do caretakers have in trauma?
  • Do people heal better as couples or individuals?
  • What's the difference between codependent & interdependent?
  • How do you gather valuable information in couples therapy?
  • What's important to assess for with couples?
  • Is couples therapy ever premature?

Check out the episode, show notes, and transcript below: 

 

 Show Notes

 

What is The Couples Therapist Couch?

This podcast is about the practice of Couples Therapy. Many of the episodes are interviews with leaders in the field of Relationships. The show is meant to help Therapists and Coaches learn how to help people to deepen their connection, but in the process it explores what is most needed for each of us to love, heal, and grow. Each week, Shane Birkel interviews an expert in the field of Couples Therapy to explore all about the world of relationships and how to be an amazing therapist.

Learn more about the Couples Therapy 101 course: https://www.couplestherapistcouch.com/

Find out more about the Couples Therapist Inner Circle: https://www.couplestherapistcouch.com/inner-circle-new

Transcript

Please note: Transcript may not be 100% accurate.

Lisa Ferentz 0:00
First and foremost, I think the deepest healing happens when the client, him or herself, is willing to turn inward and to reconnect with and to bring a lot of affirmation and love to the wounded younger part inside of them.

Intro VO 0:19
Welcome to The Couples Therapist Couch, the podcast for couples therapists, marriage counselors and relationship coaches to explore the practice of couples therapy. And now your host, Shane Birkel, Hey,

Shane Birkel 0:37
everybody, welcome back to The Couples Therapist Couch. This is Shane Birkel, and this is the podcast that's all about the practice of couples therapy. Thank you so much for tuning in. I'm a licensed marriage and family therapist, and I do my best to bring you the best in the world of couples therapy. This week, I was able to catch up with Lisa ference, and we had chatted way back in 2019 in episode number 74 so if you enjoy our conversation today, you can go back and check that out as well. She is the founder of the ference Institute where she educates mental health professionals in advanced trauma treatment. So she and I talk all about relationships and trauma, and we have a really great conversation. But before I get to sharing with you the interview, I wanted to tell you again about TheraBundle. This is the last week that you'll be able to sign up. I think the last date is November 21 so if you're thinking about that, definitely take a look at the link. I'll put a link below, but it's, you know, you'll get access to 60 courses for $100 so basically, a bunch of therapists, you know, provide, basically give their courses, and also business experts. There's a bunch of them on how to, you know, set up your therapy business, or how to do different things with your therapy business. So you pay $100 and you get access to all 60 plus courses from the therapists and business experts. So it's a really good deal. Click on the link below, you'll get a discount with that, and let me know if you have any questions. But without further introduction, here is the interview with Lisa Ferentz. Hey everyone. Welcome back to The Couples Therapist Couch. This is Shane Birkel, and today I'm speaking with Lisa Ferentz, expert in trauma, with over 40 years of experience, and Founder of The Ferentz Institute educating mental health professionals in advanced trauma treatment. Hey, Lisa, welcome to the show.

Lisa Ferentz 2:46
Thank you. I'm delighted to be back with you. Yeah, for

Shane Birkel 2:50
those who enjoy this episode, they can go back. Actually, I'll have to look. I'll put it in the show, in the show notes, and I'll put it before this. What the episode number was, but it was over five years ago that you and I spoke before

Lisa Ferentz 3:04
Yes, and we're both, we're both much wiser now, right,

Shane Birkel 3:07
that's right, exactly, exactly. Well, we'll talk a little bit about how trauma impacts relationships, but before we get into that, why don't you tell everyone a little bit more about yourself? Sure.

Lisa Ferentz 3:19
So I do specialize in treating trauma, and I've my practice has, has sort of covered young children, adolescents, adults, couples, certainly, and individuals. I love bringing a lot of different treatment modalities to the work that I do. So I'm not wedded to any one model, which I'm actually very proud to say, because I think taking an integrative approach is probably the best way to provide the most amount of support and help people access their own wisdom. And I have an Institute in Baltimore where we train clinicians to work with trauma in our 18th year, which is really quite amazing and wonderful, and I provide a lot of consultation to therapists, both beginning therapists, and therapists who are actually quite seasoned, who are working with trauma. And I've written several books on the subject. And I feel just very, very privileged to be able to continue to really now that COVID has over, travel the world again, to be able to train clinicians to be truly trauma informed in their approach to treating their clients?

Shane Birkel 4:26
Yeah, absolutely. And I just find it to be so helpful, especially when we're working with relationships, to sort of understand how those experiences impact what's going on in the present.

Lisa Ferentz 4:37
You're exactly right, and I think that when you, when you're when you're not looking at a couple relationship within that context of trauma, then you miss a lot of the key pieces. It's easier to go down the road then of pathologizing one or both of the folks in that relationship, and when you are able to look at them through a trauma informed lens and begin to. Understand the impact that their past experiences have had and the ways in which those experiences get reenacted and rekindled. You know, in the relationship, then so much more about them makes sense. And I think we're able to be far more effective as clinicians in terms of how we help to support and to guide those couples in in their relationships? Yeah,

Shane Birkel 5:22
absolutely. It helps them become conscious of what's going on and hopefully more intentional about what decisions they can make. But, but also, I think it helps the partners move into compassion for each other. Like, you know, there's some reason why it makes sense that my partner's doing this, and the more they they can be have that consciousness about it, I think the better they can do. Exactly right?

Lisa Ferentz 5:46
Shane, and you know, that's a really important thing to assess for. I think when you're working with couples, are they able to hold empathy and compassion for each other? Some, I will tell you, sometimes it's easier when they're both coming with a backstory of trauma or abuse or neglect, there's just an intuitive and sort of cellular understanding of what their partner might be grappling with. So sometimes that makes it a little bit easier for them to summon that empathy and that compassion. It can be a little bit trickier when only one person is coming with a trauma history and the other is not. Sometimes it is harder, you know, for the non traumatized person to be able to summon and hold the necessary empathy and compassion. It's harder, I think, for the person who's not traumatized to not take it personally. You know, when things come up in the relationship, and I think that if they're both coming with a trauma background, there's almost a shorthand understanding, I think, both verbal and nonverbal, between the couple, that they can readily remind each other that this is about their past. This is not something to take personally. So yeah, in those instances, I think it's easier for them to access the compassion and the empathy. So you should definitely assess for that, because you want to strengthen that, obviously, if it's not there enough, because that can really get in the way of the couple being able to heal and move forward together.

Shane Birkel 7:09
Great. And I want to ask you a little bit about how you assess for that, but I want to take a step back even before that, if you could just define what you mean by trauma. Because, you know, I think that, you know, when you're talking about the non traumatized partner, there's part of me that was like, Oh, do are any, do any of us, does that exist,

Lisa Ferentz 7:31
right? No, I get that. You know, I'm actually delighted you asked, because the truth is, what I've learned after doing this work for a very, very long time, I think we tend to focus on, you know, what happened to the person, and if it was something, if they were sexually abused or physically abused, if, if they grew up with a lot of neglect, if they grew up with a lot of discrimination, or they felt very marginalized, it's easy for us to kind of conclude that that's probably trauma. But what I've learned from my clients over the years is that actually what becomes more important to ask about is the meaning that the client attaches to their experience. I have worked with folks who you know, objectively speaking, have really been to a tremendous amount, and they don't necessarily consider themselves to be traumatized. They're very, very resilient. They've used those past experiences almost as a source of motivation, you know, to move themselves forward in life. They've made very intentional, unconscious decisions to break the generational cycle, let's say, of neglect or physical abuse. And they're doing it very, very differently, you know, in their own parenting and in their own relationships. So, you know, generically speaking, when somebody has been put in situations that in some way challenges their sense of safety, their sense of protection, in some way violates their sense of privacy or their body, yeah, we, we tend to, you know, start from the place of thinking, Gee, that probably was trauma. But it's equally important to really talk about the meaning making that the client brings. And I'll even be more specific than that, because when the client personalizes their experiences, it was my fault, or I deserved it, right, or I should have done something to prevent it or to stop it. That's going to add layers of trauma to the experience that is going to make it harder for the client to be able to metabolize and then transcend their experiences. But when the client is able to recognize this was not my fault. There was nothing that I did to you know, evoke this. This was 100% the responsibility of the person who hurt me. That really frees them up pretty dramatically there. Obviously, there may still be sequela that you have to deal with, you know, some feeling of confusion or grief or or sadness or anger, and those would obviously be very legitimate emotions to have. But if we can help clients move down that that. Trajectory towards I really understand this was not my fault, and it's about what happened to me. It's not that there was something fundamentally wrong with me. So that's an important distinction, you know, to make. How our clients continue the narrative they tell themselves really about, about what happened and with couples, then you also want to listen for the narrative that they hold about their partner's experience. And believe it or not, there are people who blame their partner, you know, for for the things that they endured in their families of origin. And then there are other partners who are incredibly gracious and are able to very easily understand that what happened to my partner. They didn't sign up for it, they didn't ask for it. It was in no way their fault. And that's helpful, because that's modeling a kind of empathy and compassion that then the person who experienced that pain or that suffering can start to internalize and and and believe and feel as well. Yeah,

Shane Birkel 10:59
and I think, and I don't know if you would see it the same way, but I feel like caretakers have such a role in that, meaning, making that happen. Yes, you know whether it's usually the parents, but if someone's experiencing physical abuse and they're being told that they're, you know, being a bad kid or something, that's very different than if they go through a car accident or something, which could be very traumatic and scary and hurtful, but but then Nate, let's say after that, they have parents who are asking them, how are you doing? Are you okay? You know, and they're sort of helping them process the trauma that happened in a supportive way. You know, that's where I feel like people end up not being as impacted by it later on in life.

Lisa Ferentz 11:42
Yes,

Shane Birkel 11:43
you know, when they sort of live in an environment with where the caretakers are telling them all the time or or communicating in a blaming way or shaming way, you know, I feel like that's going to have a much different sort of impact.

Lisa Ferentz 11:55
You know, you're exactly right, Jane, and use the word shame. And I think that, you know, that's really a cardinal feature, that when the child is told you deserve this, or this is your fault, or if you were a better kid, I wouldn't have to hurt you in this way, then you really are instilling a sense of shame. And I think shame and guilt for me are different. I think, you know, we can hold a feeling of guilt for something we've done, or something that we wish we had done, or something that we said or we didn't, you know, wish we we didn't say. But shame, I think, is much deeper. It's about who you are, fundamentally who you are, and when you're told by by people you trust, and you're right, it's typically the caretaker that you are deserving of, this maltreatment that goes to the core of the child's sense of self, right? I am unlovable, I am worthless, I am stupid. I don't deserve to be protected. And so it's that shame, I think that really creates all kinds of subsequent struggles for people. And I think again, in the field of trauma treatment, we have to keep working to really disentangle who you are from what happened to you, because oftentimes, for clients, they are defined by their trauma, you know, and we want the clients we work with to know that they My goodness, they are way more than what happened to them. Certainly, what happened to them can be extraordinarily impactful and formative, but they are still more than what happened to them. So working on shame, again, it's a very important aspect of the overarching agenda for trauma treatment and checking to see in a couple, in a dyadic, you know, relationship is there the deliberate or the inadvertent promotion of shame, because that's that's going to compromise the other person's ability to be able to heal?

Shane Birkel 13:53
Yeah, and I, you know, in couples, I think, you know, where you have two adults communicating with each other, you know, I think that guilt can be something that's very healthy, you know, like I feel bad that I hurt you, yeah, and it motivates me to be accountable and to to be sensitive to my partner's feelings and things like that, versus the shame, where it feels more like I'm spiraling into, well, I'm such a terrible person, and I'll never get it right, kind of like, like you said more about my character, or something like that, yeah,

Lisa Ferentz 14:27
yeah. And you, you are right to suggest that again, with guilt, guilt can be motivating, right? We look i We have to be careful, because I know clients who who beat themselves up with guilt as well, right? But, but there is a place for using guilt to gain more self awareness, to apologize, to make amends, to commit to changing your behavior in a certain way. So from from that standpoint, guilt can be motivating. My very strong belief is that shame is never motivating. Shame is paralyzing. People don't really. Move forward if they continue to tell themselves that they're worthless or they're stupid or they're bad. So we do want to disentangle, you know, being accountable, taking responsibility, just as you suggest, if I've said or done something to hurt my partner, really important that I can own that. Really important that I can find ways to repair that with my partner, but that's not the same thing as shame. And I just see shame as not motivating and pretty incapacitating, you know, for a lot of clients, yeah.

Shane Birkel 15:31
And you made me think of something else too, which is, you know, a lot of times when people aren't conscious of the shame, they might approach the situation sort of like, in a defensive way, like a right and wrong thinking kind of way, like, because they're protecting themselves from, you know, like, I didn't mean to hurt you, or something like that. Like, I, I don't want to get overwhelmed with shame, so I become defensive and minimizing of the other person's experience, or invalidating, which I think we see in couples therapy a lot, you're

Lisa Ferentz 16:04
exactly right, and you know, for the person receiving that, you know, either I'm sorry you felt that way, right, or I didn't mean to hurt you, that is not satisfactory, right? That does not feel like taking that feels like an abdication, really, of ownership and responsibility, and doesn't really move the couple forward. I think you're right, though, that in a therapy session, oftentimes therapists have to help clients to finesse how they take ownership and responsibility, because either they don't take it or perhaps they take it in a way that just exacerbates shame. So you know, there's you have. You have to sort of help, I think some folks finesse how they talk about taking that ownership, so that again, they're not beating themselves up and they're not going down that rabbit hole of shame. And yet, for their partner, it feels like they are truly taking responsibility and accountability.

Shane Birkel 16:59
So to go to go back a little bit when you're starting to work with a couple, let's say, Are you, are there anything directly that you're doing, or you just sort of keeping your radar on, as far as, like, you know, how is the trauma impacting this? Or do you, do you have specific questions that you try to ask people soon, pretty soon on in the work,

Lisa Ferentz 17:23
yeah, you know, it's funny, because I get asked that a lot, and I my, I think I do not take a formulaic approach to, you know, to treatment and to being a therapist. My belief is that every person, every couple sitting across from me, is unique. And, you know, it is important as a trauma informed therapist to have a fundamental understanding of things like, what is the impact that attachment has. So I do at some point in the process, do like to get a lot of information about each person's family of origin experiences, particularly as that pertains to attachment. Because what we know now is that when you're not given the predictable, consistent, secure attachment that every child needs and deserves, we know there are profound consequences, and that certainly not getting secure attachment is going to show up all the time in interpersonally, and you know, in terms of the partner that you choose, in terms of the way in which you do or don't communicate effectively the extent to which you can or cannot do self advocacy and self protection. So understanding their family of origin experiences, for me, is hugely helpful and important. I think that, and I'm very clear about this, this is not about masochism. I don't think that anybody deliberately seeks out to reenact and replicate abusive or unsatisfying relationships. But I think unfortunately, if in your family of origin you did not have the experience of nurturing, safe, loving, secure attachment, then your relationship template is really not a healthy one. And so it's not that you're wanting to be re traumatized or mistreated. It's that, unfortunately, that dynamic has now been normalized for you. So we all get, I believe, a relationship template, and that really comes from our most formative experiences with our primary caretakers, and that kind of normalizes for us. This is how you should expect to be treated in the world. This is how you, you know, can expect to be seen and heard and understood, or not seen or heard or understood. And unfortunately, it's very, very common for people who did not get secure attachment, people who either had parents who were very rejecting and dismissive or had very anxious attachment, where sometimes the parent was available and other times the parent was completely unavailable. Unfortunately, statistically, they're going to reenact those dynamics in their subsequent relationships. I always like to help my clients make sense out of their. Experiences, why they struggle with, what they struggle with, why they gravitate towards the kinds of people they gravitate towards. And for me, when I can put their experiences into that family of origin context, that's a great way to help clients understand, you know, why they are currently experiencing, the confusion, the suffering, the, you know, being in a relationship that doesn't feel fulfilling or doesn't feel supportive, there's a backstory to that. So I do like to learn about that backstory, and I think in couples therapy, it's a very powerful thing when one person can witness the other person's backstory, right? Sometimes, you know, I've had couple sessions where one of them will start to talk about trauma or abuse or neglect in the past, and their partner sits there and their jaw drops because they had no idea, you know, that that's what their partner endured. And suddenly it's like you're connecting dots. You know, if that was your backstory, if that's what got normal is no wonder this is something that you struggle with about now. No wonder it's hard for you to sustain trust. No wonder intimacy feels you know, confusing or or feels triggering for you. So there is something to be said about in a safe way, obviously allowing the partner to be a compassionate witness, just like the therapist is a compassionate witness to the other person's past experiences. So I definitely do like to get that information, but it's not like I'll say to you, I do it in session two or session five. That's gonna dramatically vary from from, you know, couple to couple and and client to client.

Shane Birkel 21:39
Yeah, yeah. And I think the way you're talking about it, it sounds like maintaining that curiosity is such an important part of it for us as a therapist, just to keep sort of being curious about those experiences. And I don't think that everybody fits in the same template. You know, that's right, if somebody had a very avoidant father and a very anxiously attached mother or something, two people could experience that and come out of it with very different personality or attachment styles themselves, that's

Lisa Ferentz 22:13
right? And coping strategies too, right? The way, the way which a person navigates those insecure attachments can also be very variable.

Shane Birkel 22:24
Yeah, great. So, and then, and then the other thing you were saying, I feel like, is the opposite of shaming, you know? So you're maintaining that curiosity as a therapist, and then you're just sort of giving them a ton of validation of, oh, like, you know, when you went through that, it makes sense that you're struggling in this way, and it's like valuing them, valuing their experience, not making it about shaming them as a person.

Lisa Ferentz 22:50
That's exactly a chain. And it's the idea for me of constantly de pathologizing, right, that everything about you actually makes sense given where you've come from and given what you've experienced. You know, I often say when I when I give trainings that, you know, therapists have this huge DSM, the diagnostic, Diagnostic and Statistical Manual, which I've gone on record many times as saying I hate it, is the most pathologizing document ever written. But I've also found over the years that clients have their own DSM. It's much, much smaller, but the way they make sense out of their struggles and their distorted cognitions is their own little DSM, and their diagnoses include things like, I'm weird, I'm damaged, I'm broken, I'm dirty, I'm bad, I'm abnormal, I'm crazy. Like, that's their DSM, whether they're conscious of it or not. So anytime we can connect the dots and help them to understand that what they're experiencing, what they're thinking, what they're feeling, the behavioral choices that they're making, actually makes sense within the context of their past experiences, we're moving them away from that shaming DSM that says I'm just broken, right? I'm just I'm just damaged, I'm just weird. That's, that's why I struggle with this stuff, and I think that's a hugely important part of trauma informed care is to help clients make sense out of themselves. You know, it's, I know you know this. It's sort of remarkable how so many clients do not connect their current struggles and spirit and experiences to their past, they do not, right, right? They'll say, Well, that happened 30 years ago, right? That that that can't be relevant to my life now, and yet we know, oh, my goodness no, you carry that with you as if it happened yesterday, right? It's still incredibly impactful and influential. So, so although it's obvious to therapists, it's important to remember it's really not obvious to clients. And when we can connect those dots and help them to understand, this actually makes a lot of sense. You know, the ways in which you've had to cope makes sense. That's what moves them away from the pathologizing and the shame.

Shane Birkel 25:01
Right? Yeah, I don't know if you I feel like I have a really hard time with people who have sometimes with people who have experienced neglect, if they experience physical abuse. Oftentimes, you know, it's very painful. You know, in the therapy process can be very painful, but people get it. It's like, Oh, yeah. Like, that was really bad what happened to me. And you sort of can do the work and process it more easily, but with people who have experienced serious neglect, you know, it's much harder. It's sort of like, well, nobody was doing anything to me, you know, or that was just normal, you know, that's what I grew up with. I don't know if you No,

Lisa Ferentz 25:38
you exactly right. And I'll tell you, even within the mental health field, I think until, not until fairly recently, we didn't put enough emphasis on asking about things like emotional neglect. You know, sometimes we hear really poignant stories about, I didn't have a coat, you know, I didn't have enough food. Again, that stuff is pretty profound. But, yeah, it's the emotional neglect. It's that lack of secure attachment. And I think you have to do a lot of psycho education with these clients to help them to understand what children are biologically wired to expect, and what we're wired to expect when you look at the parent child relationship is the dance called serve and return. So children constantly throughout the day are doing serve, right? They're in infancy. They're crying in order to get their response. As they get a little bit older, they use their voice, they use a smile, they use their behavior. But in that process of reaching out the the absolute biologically wired expectation is that I'm going to get a return, a response from the caretaker, and that that return is going to be safe and loving and validating, right, and nurturing, and so it's actually quite profound and even devastating for a child when they're doing serve over and over and over and they're not getting the nurturing, safe, predictable return that literally is in their wiring to want and to expect. And again, what many children do as a byproduct of that is they begin to shut down. So they become very overly self reliant. They stop doing serve right, because children are very smart, they realize at very young ages, it's too painful to keep reaching out and feel rejected. It would be less painful if I just stopped reaching out, and that has devastating consequences as they move into adolescence and adulthood, because these are folks who are emotionally shut down. They're people who don't trust understandably, there are people who really struggle with intimacy. They're people who don't want to allow any kind of vulnerability, because their assumption is it's going to be ignored, you know, or it's going to be rejected. So these are folks who become pretty isolated at times. They can feel very lonely and alone, and of course, this has profound repercussions if they're in a relationship, because this is the person where their partner sits in therapy saying, I just need you to tell me what you feel. You know. I need you to communicate with me. I need you to tell me. And the person who's really struggling with being able to articulate their needs and their feelings, in all likelihood, is somebody who was very neglected, and stopped trusting understandably, and discovered that when you do serve, you don't get return.

Shane Birkel 28:28
And how much I mean from the I love the way you're sort of setting, that there's sort of a way that, you know, humans, from the time were born, as children were sort of, you know, I think there are some foundational principles about, you know, what it means to be human and what we need as human beings. And you know, when we move away from that, then we see the effects of the trauma oftentimes as people grow up. So I love that. I'm wondering, you know, when you have a couple who's coming to therapy, two adults, what level of involvement does their can their partner have in sort of healing their own stuff? Or is that primarily, you know, their own individual work for themselves?

Lisa Ferentz 29:13
It's a great question. Shane, I think it's both first and foremost. I think the deepest healing happens when the client, him or herself, is willing to turn inward and to reconnect with and to bring a lot of affirmation and love to the wounded younger part inside of them. That's the client's ultimate superpower. And so that's something I think, in therapy that we really want to strengthen in that client. Because the truth is, you can have a very loving partner, but you know, everybody has their own stuff, and people get preoccupied and people don't feel well, and people are tired, and so it's not like we can always count on our partner right to be there for us, to affirm and validate us. I want my clients to know that even when they're part. Partner for whatever the reason can't totally come through for them that they're not going to be bereft of that resource of comfort and soothing and self love. So I think ultimately, yeah, that's where the deepest healing happens. And I think that the relational piece is hugely important, just like the therapeutic relationship can bring in tremendous repair around secure attachment. There's no question that for many clients, the first place where they experience reparative secure attachment is in the therapeutic relationship, because it's a truly unconditional relationship, right? We're not going to get upset with our client if they disagree with us. We're not going to give up on the client if they don't, you know if they want to do something different than maybe what we wish they would do or hope that they would do. So it's a uniquely unconditional relationship, the therapeutic relationship within the partnership with with the other person, the extent to which we can help strengthen unconditional regard. Yeah, we want to do that for sure. And if a client is working on their own growth and their own healing and contextually, they're in a relationship or a marriage where they're being ridiculed or emotionally abused or sexually violated, that's going to keep compromising the client's ability to grow and to heal. So we really are looking for a combination of the client's own ability to to love themselves and to and to again turn inward and bring that comfort to the wounded younger part, to reframe any cognitive distortions that they still hold about what happened to them. And it's hugely helpful when you're also getting simultaneously the support of of your partner.

Shane Birkel 31:45
Yeah, that's that's great. I think sometimes couples have a hard time. I mean, usually more of an anxiously attached person will will sort of perceive that if my partner isn't taking care of me fully, then this isn't a healthy relationship or something like that. But I think, you know, I agree with what you're saying. If we if both people are taking care of themselves and have that ability, you know, it's going to look like a very healthy relationship that they can offer support and love and care for each other. But it's not, you know, it's sort of not co dependent. It's not dependent on each other to be okay.

Lisa Ferentz 32:24
That's right, that's exactly it. You know, it's a great distinction between codependent and interdependent, right? You definitely want to feel like your partner has your back. You definitely want to feel like this is, this is your person, and this is somebody whom you can trust everybody deserves to feel that that's an interdependence where each still individual people, we are taking responsibility for taking care of ourselves and healing ourselves, and we are simultaneously sort of cheerleading and supporting the work that our partner is doing as well. And I think that you get the deepest and best healing when both those things are operational, that there's that internal work happening, and there's also this incredible feeling of this other person cares about me and has my back. I always say that, you know, the three things that as humans, we want is to is to feel seen, heard and understood. And everybody deserves to feel seen, heard and understood in their relationship. By the way, understood does not mean agreed with. I like to make that distinction as well, right? Because teenagers in particular that you know will say to their parents, you you know you don't understand me? No, I totally understand you. It's just we're disagreeing about something, and I find that that can carry over into adult relationships as well. So you know, you don't have to be in total agreement with your partner, of course not. And you have to feel respected, and you have to feel understood. You have to feel that even if there's a difference of opinion, the difference is not negating or minimizing, you know, each individual opinion so feeling seen, heard and understood, I think that, again, it's in our DNA. It's what we're wired to want. Every person deserves it. It is part of the definition of secure attachment. And, you know, the research says only 50% of children actually get secure attachment only 50% so there are, you know, countless children walking around with insecure attachment of dismissive or ambivalent or disorganized, and there's no question that that plays out in their subsequent relationship dynamics and and choices that they're making in terms of, you know, who they're with,

Shane Birkel 34:43
yeah, and I a lot of times, people will come in and say, we just need communication skills, right? And they really do want to feel seen and heard and understood, and it's sort of like we can teach them those things. But it's interesting to see what happens when they try to use. Them, how that, how that trauma comes through and makes it hard for them to use the skills, right? Yeah,

Lisa Ferentz 35:07
you're exactly right, and that's why, look, I think, at the end of the day, and I don't, I'm curious, actually, what your opinion is about this, Shane, because sometimes I've worked with client, with couples, where I feel the couple's therapy is actually premature. There's so much individual work that has never been addressed. You see it sort of playing itself out in the couple's therapy, where it really creates a kind of roadblock for forward movement. So there have been times, whether I'm working with a couple or I'm consulting on a case for another therapist working with a couple where I have said, you know, I'm wondering if maybe the first step in the process is for each person to get some of their own individual therapy, to gain some insight and awareness about who they are and what they've experienced and the impact that those experiences have had so that then when they move into couples therapy, there's a wisdom, there's an awareness that they can bring, that they can share with each other, that helps them to better understand how their individual stuff is then being played out in the couple's work. But I don't know if that might be controversial. I don't know. I think that there may be some couples therapists who feel like you just always do couples therapy first.

Shane Birkel 36:26
No, that's a good it's a good question. And I love what you said earlier. And I do the same thing where sometimes there are opportune moments to do some individual work with the partner, sort of as a compassionate witness. Yeah. And I think that can be really beneficial and meaningful for the work. And in fact, you know, I've actually done, you know, a full hour just with one person and the other person's just sort of witnessing, yeah, you know. And I think that can be really beneficial. But I absolutely think that there are times where each partner, or maybe one partner needs to do a separate individual therapy, and it needs to be defined that way. What I think is that when it comes to couples therapy, that can be a really important place, even when that individual therapy is happening where we're defining, like, what, what goal? What are our goals together. You know what? If you're going to go to individual therapy, how is that going to help you show up in this relationship? And so that, you know, the couple's therapy could be more of just a continued making sure we're on the same page about what the game plan is, making sure, you know, we we both understand why we're doing the individual work that we're doing, and how that's going to help us show up in the relationship. So I think they can often work well together, sort of, yeah, same time, yeah. It worries me a little if you just say, all right, both you need to go to individual therapy, come back in six months, couples therapy. To me, that concerns me a little, because will they really know like that there's no place for the relational conversation to happen at that point. No, that

Lisa Ferentz 38:07
makes sense. And as I think about it, I you know, I realized that there are a lot of individual people I'm working with, both male and female, who are also simultaneously doing couples therapy. And as you're suggesting, I think in the individual work, we are always trying to link it back to can you bring this insight into the couple's work? Can you see how this insight is impacting how you're showing up or not showing up in your marriage or in your relationship? So, you know, yeah, I think if they're willing to do it simultaneously, that's probably where you get the best result.

Shane Birkel 38:43
Yeah, and I love collaborating with couples therapists. Yes, if I'm the individual therapist, I feel like I can summarize things in, you know, 10 minutes and, you know, but if, if I'm listening to the couples therapist, that's where there's so much insight happening, like, how, how is, how are these things showing up in this person's life? Yes, because, as an individual therapist, we only get what they tell us, which hopefully pretty good overview.

Lisa Ferentz 39:10
But yeah, it's

Shane Birkel 39:11
really interesting to hear the couple's therapist experience of, like, wow, how? How do you see this showing up in the relationship?

Lisa Ferentz 39:18
You are, right? And every once in a while, you hear a narrative from a couple's therapist, and you're sitting there thinking, are we talking about the same client, right? Right? Because what I'm witnessing, what I'm, you know, observing in the individual therapy is really different. And boy, is that. Is such valuable information to have, you know, you get a much more expansive picture about who that client is, and again, how their individual stuff is showing up in the relationship.

Shane Birkel 39:48
It's interesting too another, even if they're not in couples therapy, sometimes, if I'm working with an individual, I love bringing their partner in for a session, not. To even do couples therapy, just to sort of hear their perspective, like, just like you said, sometimes that'll I'll be like, Oh my gosh, are we talking about the same person? And all of a sudden we'll have five sessions worth of stuff to work on. You know, that wouldn't have come out otherwise,

Lisa Ferentz 40:17
yeah. And I think when you're dealing again with somebody who comes with trauma, any opportunity you have to provide psycho education for the partner is going to be valuable again, especially when the partner doesn't have a trauma background is not just not well informed about what it means to be with somebody who's been sexually abused for five years. You know in their past that psycho education is hugely helpful, and I will add, particularly around sexual issues and issues of intimacy. Because if you're dealing with an adult who is sexually abused and it's not been resolved, it's going to show up, you know, in the intimacy, whether it's that that person is in flashback, or they always have to be drunk or high in order to be sexual with their partner or and this can be very confusing to the non traumatized partner. There are plenty of people who literally have to reenact their sexual trauma in order to experience arousal or orgasm, and that's because their brains and their bodies have paired violence with sexual arousal. You know, the things that they learned very, very early on when they were being abused. And so I've worked with couples where the guy is being put in this terrible position that that she wants him to be aggressive, she wants him to be verbally abusive. She has to pretend that She's five years old in order to be aroused. Incredibly confusing, right to to the the male partner, and so in those instances, I always really, really firmly suggest that they bring their partner in for a couple of sessions, just so that I can provide that psycho education help them to understand why this is playing out, and then really work with them a little bit as a couple, to give them new ways to be intimate. Because if that person continues to reenact, you know, the sexual scenarios of abuse from the past, they just keep solidifying that that neural pathway in their brain. So to be able to say to that couple, listen, you have to start having sex with the lights on, with eyes open, you have to talk to each other so that she stays grounded and knows that you are her partner and not her father, not her brother. You have to understand that if she starts to go into flashback, you stop, right? You stop what you're doing. So I don't expect anybody who's not been in therapy or is not a trauma survivor themselves to know any of that, so that, you know, bringing the the partner in for psycho education hugely important. Just like, if you assess that the person you're working with has an addiction of some kind, you want to bring the other person in, you know, so that we can do that psycho education and and talk about ways to support their recovery. So, yeah, bringing in, you know, the other stakeholders can be hugely important.

Shane Birkel 43:05
That's great. And I'd love to ask you, you know, if there are therapists out there who are interested in getting more education and trauma, to become more trauma informed, and I definitely encourage you to talk about the fairness Institute as well. What you know about what you have to offer with that as well?

Lisa Ferentz 43:25
Yeah, the good news is, is that I think now, because the phrase trauma, informed care gets thrown around all the time, you know, I do in service trainings for a lot of different agencies and, you know, community mental health organizations and they want their staff to be, quote, trauma informed. The problem is, there's not really universal definition of what we mean by trauma informed. So I think we still have to really clarify what that means and what that is. But yeah, in my 41 years of doing this work, I've seen a very wonderful improvement in therapists wanting to be more trauma informed and wanting to understand the impact that attachment trauma has, that marginalization and discrimination have, that neglect has, that sexual abuse has. So yeah, and that's why I think, Thank God our institute is in its 18th year. We've graduated several thousand clinicians in my certificates and advanced trauma treatment. Because I think people really do want to know, how can I be more trauma informed? I mean, I don't know about you, but when I went through grad school, I learned nothing about trauma, and, I mean, nothing. Now, it's a long time ago. It's like 4344 years ago, but I was, you know, I was seeing clients in Baltimore City, a population of extraordinarily traumatized folks, and there was no conversation, and there were no classes that talked about trauma, how to work with it, how to understand it, how to assess for it. And so we need to know how to do that, you know. And as you said in the beginning, and I think you're right, like. Is there such thing as a person who doesn't have some experience, you know, that was traumatic or formative, or, you know, temporarily painful for the client? So, yeah, understanding the impact that trauma has vitally important, vitally important to this work. Yeah,

Shane Birkel 45:16
great. And what and what are specifically the types of courses that you offer. So

Lisa Ferentz 45:21
we have two certificate programs in advanced trauma treatment. They're each 54 hours, and they really focus on understanding what trauma informed means. And I will tell you, part of what trauma informed means is knowing that trauma and traumatic experience is stored visually and viscerally on the body. So what that translates to mean is you have to be well versed in a lot of different modalities. You can't just do talk therapy. So understanding how to work with the body hugely important, understanding how to work visually, whether you're using art therapeutically or sand tray, you know, working with the dreams that people come in with, because that's really the first sort of place where trauma begins to get brought into consciousness and metabolized. So understanding the creative modalities that are necessary to weave into the work is hugely important. So those two certificates really focus on walking people through how to incorporate these creative strategies. We talk a lot about attachment trauma and really understanding what that is and the impact that that has on clients. So those two programs really, really home in on on that we alternate. They're offered online and they're offered offered also in person in Baltimore, where I am located.

Shane Birkel 46:35
Oh, great, great. Yeah. Thank you so much. Anything else. But you know, as we're getting to the end here, anything else you'd like to mention, or any other thoughts about these topics in general?

Lisa Ferentz 46:47
No, look, I'm just delighted that you were talking about this and that you want to talk about this. And I think that when we're working with couples, so much of what they struggle with really does have its roots in each person's experiences from the past. So I do like to say that although CBT can be a beneficial modality, for sure, because we want to help people to be able to have narratives that are loving, we want self talk to be positive and compassionate. I focus on that a lot, and it's not just CBT. We really have to put people into a family of origin context. We have to really ask a lot of questions about what got modeled for them. What did your parents marriage look like, right? What did your siblings marriages look like? Because, because all of that gets normalized, you know, for our clients and so understanding what got normalized, understanding how they were treated, how they were not treated. It's all going to play itself out in their adult relationship. So the more we can help our clients make sense out of what got normalized and what got modeled and what they didn't get right, what they were not able to gain mastery over, the more we help clients make sense out of their set themselves, move them away from shame, and then help them to learn new ways to to be in partnership, because people absolutely can grow and heal and change. I will say one last thing that I've learned over the years in working with couples, you're not going to change your partner. That's not going to happen, right? We don't fix or change other people. And so it is important, and that is something I do assess for early on in treatment. You know, what is your agenda? If you're here to change your partner, it's not going to work if you're here to work on yourself and your partner is willing to work on him or herself, she you know that will automatically produce shifts and change in the relationship. But it is important for people to let go of the idea that if I just do X, Y and Z, I'm somehow going to be able to change another person, because doesn't happen. Yeah,

Shane Birkel 48:48
you and I could probably do a whole other episode on that topic. Yeah, really helpful, because people, a lot of people, come in with that mindset. But you know, I really appreciate everything you're saying. Thank you so much, Lisa, it's really always good to talk to you. Yeah, you too. It's gonna, let's make it less than five and a half years or whatever. Absolutely. Okay, great. All right, take care. You too. All right. Thank you so much, Lisa, and thank you to all you listeners out there. I'm so grateful for all of you. Definitely go to couples therapist couch com to find out more. You know, check out more episodes, find out, get more the free courses. But also remember, this week is the last week to sign up for the TheraBundle. It's 60 courses that you get for $100 you get access to all these different courses from different therapists. And I donated a my course that usually it's $97 so you basically, if you want to take that course, you basically get that covers the amount that you would pay for the whole TheraBundle. But it's a course on how to do intensives, how to set up your intensives, what to think about if you're thinking. About doing couples intensives, so I'd love for you to check that out and let me know if you have any questions. But thank you all so much. This is Shane Birkel. I'm q licensed marriage and family therapist, and this is The Couples Therapist Couch. Have a great week, everybody!

 

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