Emotionally Focused Therapy with African American Couples by Paul T. Guillory

Author:Paul T. Guillory
Language: eng
Format: epub
Publisher: Taylor and Francis
Published: 2022-10-15T00:00:00+00:00

Therapist’s Reflection

Throughout the sessions, I am attempting to slow the process down and understand each one’s experience, with empathy. This is difficult for two reasons: First, both Marquis and Anastasia interrupt each other as they are having their say, and each one has much to say. Both can be hard for me to interrupt when they are talking and their partner is triggered. Second, their complaints can be harsh and critical, reflecting their histories; Marquis’s illness concerns; and their currently stressful lives. Each of their trauma histories, in particular, influences their reactivity. Cultural differences play a significant role, exacerbating Marquis’s sense of isolation fears regarding medical treatments and his personal history of managing his emotional life alone. I empathically reflected that negotiating critical medical treatments alone as a Black man can be dangerous, and yet that is the way he has learned to cope with stress—to do it alone. We spend time processing his racial distress cue associated with being a Black man receiving medical treatments, that is, he is prescribed medications safe for White people but dangerous for Black people. I also reflect how carefully Anastasia talks about Marquis’s medical treatments and how difficult it must be for her that she can’t be involved with his care. Finally, I reflect how hard it was for Anastasia, having grown up in a demanding, critical family and how fearful and helpless she must have been regarding her father’s explosiveness. I thought about how difficult experiencing the war and being a refugee was for her, too. These experiences contribute to her reactivity and a strong need to express herself and fight back when challenged.

Developing positive encounters can be difficult with this couple. Typically such encounters have occurred when Marquis expresses moments of physical pain and Anastasia leans in to comfort him. Anastasia can also reach out for Marquis on occasion, and he expresses joy as she does this. External stressors, their historical traumas, Marquis’s illness, matters of race and culture, and their relationship negative cycle make the work slower in stage one of EFT work. This couple gets stuck in negative interactive patterns because of the enormous stressors they have to manage, just as Marquis’s illness limits his stress tolerance and his ability to be emotionally vulnerable. The following presents a very moving moment in therapy (now working remotely) which suggests both the progress of the couples work toward de-escalation and some of the challenges to assembling Marquis’s emotions because of the cognitive confusion caused by his AD, when that is combined with his emotional vulnerability:

Anastasia: I think we are in a good place together, and it seems everything is gelling as a couple.

Guillory: Marquis, what is it like for you to hear that from Anastasia that for her it is a good place for you all? (Lean into the remote screen and we’re all smiling. Evocative question).

Marquis: It is nice to hear. It was a particularly challenging week with Angelo’s behavior, and there was a potential for things to go badly. I did start to escalate for us, and we did some things differently.

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