How Understanding Attachment Can Drastically Improve Your Relationship: A Review of Hold Me Tight by Dr. Sue Johnson

There are many theories and countless books about what makes relationships and marriages work.  Self-care and relationship sections at bookstores are filled with plenty of resources to offer marriage advice, not all of which is reliable or helpful.  But when all these tools coincide with increasing divorce rates, we are left wondering: how can couples make it through some of the worst moments of their relationship?

If you’ve been in a relationship with high levels of conflict, negative spirals you can’t seem to escape, and a sense of growing distance between you and your partner, the discouragement can feel overwhelming.  What’s the solution to these seemingly endless loops in which couples find themselves that propel them to consider divorce?

“To achieve a lasting loving bond, we have to be able to tune in to our deepest needs and longings and translate them into clear signals that help our lovers respond to us.”

— Dr. Sue Johnson

Hold Me Tight

In her book Hold Me Tight, Dr. Sue Johnson uses the lenses of attachment theory and neuroscience to explore how some couples overcome the destructive patterns in their relationship to forge a stronger connection.  She pulls together research from various studies on relationships that highlight the themes of attachment.  She then translates these concepts into seven practical conversations that help you explore the application of these concepts to your relationship.  They focus on how to turn challenging patterns of argument and conflict into opportunities to create connection and empathy.

This book is written for the everyday couple.  She explains clinical terms in a way that makes sense to someone who has never heard them before, and she uses frequent examples of couples going through challenges to illustrate the points she is making.  Counselors can also benefit from reading this book, however, as I know I was able to glean some practical tips and language that can help me guide my clients in their relationships. 

What I Appreciated

“Emotional Safety” and Other Terminology

Dr. Johnson’s use of terms like “emotional safety” take the heady, intellectual concepts of attachment and translate them into clear, relatable language.  Emotional safety is what we long for in relationships: the ability to know that our partner is Accessible (Are you there? Can I get to you?), Responsive (Can I depend on you to be there for me emotionally?) and Engaged (Am I valuable to you?  Will you maintain closeness with me?).  She teaches how to use what she coins A.R.E. conversations (based on accessibility, responsiveness, and engagement) to get at the heart of what is happening within connection and disconnection.

In fact, much of her language is descriptive and easy to remember.  For example, she uses “Demon Dialogues” to identify common patterns in faulty communication.  She introduces “Hold Me Tight” conversations, in which partners talk about their needs for emotional safety and connection that exist behind a conflict, inviting empathy and compassion.

Providing a Contrast to Cultural Messages

Frequently, Dr. Johnson contrasts our culture’s emphasis on independence and self-sufficiency with the reality of what makes couples work: mutual support, emotional bonding, and healthy meeting of emotional needs.  Often our culture decries weakness or dependency on anyone, encouraging us to stand on our own.  Even language surrounding codependency can swing toward this extreme of isolation through independence.  Her work in this book is meant to shift the narrative around healthy emotional support and depending on our spouses to meet emotional needs, particularly as larger social connections have been decreasing.

Conversations about Arguments and Hope

In the seven conversation topics Dr. Johnson proposes, she includes addressing arguments and conflict head-on, as they often carry the charge of longing for emotional connection behind them.  However, she doesn’t stop there.  The later conversations dig into such topics as improving daily moments of connection, creating rituals that reinforce your love, and improving your sexual relationship.  The earlier conversations around conflict and emotional needs lay the groundwork to make these later conversations go more smoothly.

“A desperate need for an emotional response that ends in blaming and a desperate fear of rejection and loss that ends in withdrawal – this was the scaffolding underneath these endless conflicts.”

— Dr. Sue Johnson

Pauses for Self-Reflection

As attachment and emotional safety are likely new concepts for you in your relationship, it makes sense that you might not know where to start in understanding your emotional needs.  Dr. Johnson leads you through personal reflection and helps you identify what she’s talking about, like your own personal raw spots based on past relationships with family or significant others.  The use of examples throughout can also help you self-reflect, as you identify what you relate to in their stories.

“Play and Practice”

In every chapter, there is at least one, if not several, practical application sections labeled “Play and Practice.”  These take the concepts Dr. Johnson talked about in the chapter and help you have a productive conversation with your partner about how they apply to your specific relationship.  These include such tools as fill-in-the-blank sentences that help you communicate with your partner about your reactions and emotional needs.  In particular, one section I appreciated near the end encouraged couples to write a summary story of the progress they’ve made in their relationship that serves as a narrative base to come back to when things start to get difficult or slip back into old patterns.

Addressing Trauma

She also included a chapter specifically targeting the challenging symptoms and disconnection that arises when trauma exists in your relationship.  I found this chapter especially helpful when thinking about addicts and betrayed partners who need to know that using these principles is still possible within their recovery from trauma.

She reminds the reader that we cannot stay isolated and disconnected in our trauma.  Instead, we need to let others, including our partners, into those dark places.  This can help make sense of the often confusing symptoms of PTSD that arise and create chaos within the relationship.

“If we cannot successfully connect with others, our struggles to cope with trauma become less effective, and our main resource, our love relationship, often begins to sink under its weight.”

— Dr. Sue Johnson

How to Use This Book

If you are in a relationship where you find yourself arguing often, unable to get on the same page, feeling unsupported, or simply not understanding each other, this book might be a good place to start.  It is helpful if you don’t think you’re ready for couples counseling yet, but could use some support and growth within communication and connection.  Perhaps you and your significant other could read the book together and work through the Play and Practice sections to learn more about one another.  I believe this book can also be beneficial if you read it separately from your spouse, but the best outcome is more likely to come if you read it together.

If you are a couple in crisis, on the brink of divorce, or unable to have the type of in-depth conversation the book requires due to a buildup of past pain or a tendency to get lost in the “Demon Dialogues,” your first priority might be instead to seek out couples counseling.  If the principles of this book interest you, I’d recommend looking for a therapist who has training in Emotionally Focused Couples Therapy (EFT), the model Dr. Johnson created based on her body of work.  You could also read this book as part of your therapy or on the side, but the best option is likely meeting with a quality couples therapist.

“We will never create a really strong, secure connection if we do not allow our lovers to know us fully or if our lovers are unwilling to know us.”

— Dr. Sue Johnson

Reintegrating Healthy Sexual Intimacy after Betrayal: A Review of The Couple’s Guide to Intimacy

Couples recovery from sex and love addiction can be a complex and lengthy process.  Even for those fully committed to the process of recovery, it can take between three to five years to uncover all that’s needed to heal a marriage.  The chaos and storm of staggered disclosures, broken trust, and faltering attempts at honesty can lead to confusion and overwhelm for both partners in the relationship.

Couples therapy requires participation and change by both members of the couple.  In the early stages of recovery, when the betrayed partner is reeling in pain and has often been manipulated, it doesn’t feel safe to make changes to support the relationship.  Individual healing work needs to be done first. Because of this, couples therapy is not recommended for most couples until each member of the couple is getting their own therapeutic support and a formal disclosure process has been completed.

The addict needs to get their individual pattern of addiction under control, and the partner needs space to process the pain of trauma that they experience.  They both need to establish support systems outside of the relationship in the form of 12 Step groups, sponsorship, support groups, and/or healthy friendships.  Boundaries need to be established and understood. Healing cannot happen in the marriage until there is a foundation of honesty, and formal disclosure is designed to create that foundation.

In some cases, couples therapy can begin earlier in the process of recovery.  Often this is when the couple needs to learn basic communication skills in order to navigate life together while going through this healing process.  Also, this can be helpful if the couple is pursuing a formal therapeutic separation and need guidance from a couples therapist on how to implement this logistically.

Let’s say you and your partner have been consistent in individual therapy, have strong social support, are committed to recovery-oriented behaviors, and have completed a formal disclosure.  Now what?  Many couples aren’t sure what to do once they’ve made significant progress in their individual recovery.  Deeper still, reintegrating or introducing healthy sexual intimacy can feel like a daunting task.  How can a couple recovering from sex and love addiction be intimate again?

Why A Couple’s Guide to Intimacy is Needed

In The Couple’s Guide to Intimacy, Bill and Ginger Bercaw give an answer to these “what next” questions.  They outline the sexual reintegration therapy (SRT) model that they’ve used consistently with recovering couples to help them achieve a level of intimacy in their relationships they hadn’t thought possible. 

The Bercaws’ approach helps to completely overhaul the experience of sexual intimacy in a recovering relationship.  Often, when sexual addiction was present, sexual experiences weren’t truly connecting or meaningful.  Physical and emotional intimacy are explored as integral parts of true sexual connection. 

Their book includes information about the SRT model and explorations of true healthy sexuality and its differences from addicted sex.  They also include a series of practical exercises (planned intimate experiences) that can be put into play by the couple, progressing gradually toward an entirely new vision of sexual intimacy.

Bill and Ginger Bercaw strongly recommend working with a CSAT couples therapist while going through this material, as much of what can arise emotionally and relationally needs space to be processed in a safe environment with trained professionals.  It is also important to maintain your individual therapy and support while walking through SRT, so you can have space to process what comes up for you individually as you begin to experiment with this new approach to intimacy.

Insights from the Book

The foundations upon which Bill and Ginger Bercaw lay their book form a series of important insights into the process of reintegrating healthy sexuality into a recovering marriage.

Healthy sexual intimacy is made possible by integrating physical, emotional, and spiritual dimensions of intimacy.

Broken trust and betrayal destroy all levels of intimacy. In particular, sexual intimacy is affected as often one or both partners are using it as a way to get something from the other, as opposed to truly connecting during the experience.  The book emphasizes the need to integrate all areas of intimacy through direct and open communication and conversations, especially as integrated in the planned intimate experiences (PIEs). 

Reprogramming sexual scripts is Essential.

Our culture’s view on sex influences our approach to intimacy. For example, we emphasize trying new things as a way to keep sexual experience interesting or “spice it up.”  This is intensified by the influence of sex and love addiction on your relationship, where the addict may see sex as a way to pursue novelty or seek the next “high.”  But these approaches are not truly connecting.  They are more focused on performance than they are on intimacy, and intimacy is the greater need.

Reviewing your own sexual history can reveal your expectations about sex.

Bill and Ginger Bercaw lead the reader to reflect on their own sexual experiences and influences on their sexuality as an exercise in self-understanding.  For example, if you have a history of sexual abuse, it likely affects messages about your body or your sexual experience.  Exposure to pornography can create distorted expectations about how sex ought to be.  A lack of sexual information, particularly in more rigid home environments, can lead to a lack of knowledge about sexual response and experience.  Even such influences as the media, peer groups, churches, and others can have an impact on sexuality. 

Early attachment relationships also have an influence on your experience of sexual intimacy in your marriage.  If you have an avoidant attachment style, you’re more likely to want to withdraw from conflict and therefore don’t talk about sexual issues.  If you are more of an anxiously attached person, sex might be a way that you confirm you are loved by someone.  If you grew up in a rigid family system, you might see sexual behavior as rebellious or a way to branch out from restrictions.

These influences need to be acknowledged and addressed before true sexual intimacy can be experienced.  You’re carrying around baggage from your past that has to be unpacked before you can enter into the relationship without expectations or judgment.  This is important as you will be able to come to know your own sexual self and your partner’s sexual self, which then creates a more intimate experience.

The end goal isn’t perfect technique or sexual experience, but expressing love and connection through being present to yourself and your partner.

An overemphasis on technique or an idealized sexual experience has probably already led you to disappointment and pain.  Instead, the Bercaws’ approach to intimacy takes emphasis off the final result, instead focusing on remaining present throughout the entire process of intimacy.  Every PIE exercise focuses on different depths of intimacy.  Many exercises in the progression occur outside the bedroom or with clothes on.  Several focus on creating more emotional and relational intimacy, which paves the way for connected sexual intimacy.

The importance isn’t to find the new sex technique that’s going to boost your pleasure (despite what some magazine covers may say) but instead to learn how to become fully present to yourself, your partner, and your experience during your intimate encounter.  

Safety and communication are necessary in personalizing your path.

For many betrayed partners, there is not a sufficient level of safety in the relationship to rush into intimacy.  The Bercaws’ PIE exercises are designed to help you grow closer, and they also encourage speaking up when you aren’t comfortable or when you need to change something.  They emphasize using talking and listening boundaries throughout their PIEs and reinforce that with an emphasis on healthy, functional boundaries, which they describe at length.

If you’re looking for additional support in understanding how you can grow in the area of sexual intimacy in your recovering marriage, Bill and Ginger Bercaw’s book and their method of sexual reintegration therapy offer useful and practical tools to revolutionize your relationship.

Stopping the Cycle of Emotional Harm in Your Marriage: A Review of The Emotionally Destructive Marriage by Leslie Vernick

What does it mean to be in an emotionally destructive marriage?  Have you felt coerced into doing things you don’t want to do?  Do you hear name-calling or contemptuous criticism when your spouse doesn’t like your choices?  Do your spouse’s words lead you to feel horrible about yourself?

These are common symptoms of emotional abuse or harm.  Others include a crippling sense of self-doubt based on your spouse’s criticism and feeling terrified of his or her rages.  Gaslighting is common: when you attempt to directly address an issue with your spouse, you consistently leave the conversation feeling as though it was all your fault.

Leslie Vernick’s book The Emotionally Destructive Marriage gives a message of relief to women who experience their husband’s emotional and verbal abuse but feel trapped and unable to change anything about it.  In this book, Vernick outlines the characteristics of an emotionally destructive marriage and explores what that type of abuse feels and looks like.  She also shatters the myths of distorted Christian teachings that cause women to doubt their experience based on overly simplistic views of women’s roles.

Since this book comes from an explicitly Christian perspective, including prayers at the end of each chapter and a focus on Biblical truths, it may initially alienate someone who doesn’t have the same faith background.  Regardless, I believe the practical tools and helpful insight she provides can be beneficial for any woman who is concerned about the state of her marriage.

Helpful Insights from This Book

An Understanding of Emotionally Destructive Marriages

Early on in the book, Vernick describes emotionally destructive marriages and gives assessments to help you identify the difference between an abusive relationship and an unsatisfying relationship.  This distinction between dissatisfaction in marriage and being the recipient of emotional abuse or manipulation can be validating to women who have been told they are simply unhappy in their marriages and they need to change their own perspective.

A Shift in Perspective on Biblical Submission

Unfortunately, many Christian women have been taught messages about the role of submission to their husbands without a full understanding of what this word means and what it requires of the husband.  Submission is not blindly going along with whatever the husband wants, particularly when the husband is asking the wife to do something she knows is wrong or will be harmful to herself or others. Looking at the way Jesus led others, it is clear that leadership means serving and looking out for the needs of those you lead more so than your own needs.  Submission cannot be forced or demanded, and it is not meant to be a power play of cruelty.  If you experience “submission” as a weapon in your marriage, you are likely in an emotionally destructive marriage.

Validation of a Woman’s Choice

Vernick allows her readers to make a choice about the future of their marriage: whether they want to stay together, separate, or divorce.  She doesn’t dictate what that choice should be: instead, she encourages women that whatever they choose to do, they do it “well.”  Recognizing that each situation is different and there is no one solution for everyone, she gives practical help for whichever option you choose.  She warns against people who claim simple solutions for such a complex issue, reinforcing that what is right for one woman and marriage may not be right for another.

If you are in an emotionally destructive marriage, you likely are not given opportunities to make your own decisions.  You are told what to do by your spouse and haven’t had much space to explore what you truly want.  Often gaslighting contributes to this, as emotional manipulation can lead you to believe your desires are different from what they truly are. She encourages you to get in touch with your own desires as part of this discerning process.

Practical Tools and Next Steps

At the end of each chapter in the book, Vernick gives specific action steps to help you explore changes you can make to move out of feeling stuck in your marriage.  At several points through the book, she refers the reader to her website for resources to download that help you begin to set boundaries in your marriage.  She has video resources available for both spouses to understand the dynamics of the emotionally destructive marriage. 

Challenges Toward Growth

Vernick knows her audience: the wife in the emotionally destructive relationship is probably the one reading this book, not the husband.  She also knows that many of these women want to change their spouse, but they have little to no control over that change.  Instead, she challenges women to do their own work: becoming more confident and supported so that they can take steps toward healing.  At one point she discusses her intentional decision to refrain from talking about reasons for husbands to become emotionally abusive: to her, it doesn’t matter how it happened, but instead that it is happening, and the wife needs to respond to protect herself and her family.

For Partners of Sex and Love Addicts

When I’m working with partners of sex and love addicts, I see the devastation that trauma causes and how it can limit a woman’s sense of personal power. It is important to allow the husband to carry the blame for stepping out on the marriage. And it is incredibly important for your own healing to recognize how these actions have affected you and how you may be responding negatively in your own way as a result.  Taking ownership over your own response can help you regain a personal sense of power.  Acknowledge the reality of the trauma you’re experiencing, but also acknowledge steps you can take to regain control over your own choices and life.

Practicing Self-Care

Healing from the trauma of an emotionally abusive marriage requires taking care of yourself and processing your own past hurt that may be contributing to your response.  Practice self-care by getting in touch with your own needs, which probably have been hidden because you’ve been focused on appeasing your spouse.  Find support through trusted friends, therapy, and support groups: you cannot do this alone.  Learn to communicate boundaries with your spouse and say “no” when you feel uncomfortable.  The best way to do this work is to get into your own therapy to explore how your actions has been affected by your upbringing and past trauma such that you respond in the unique, particular way you do.

How to Communicate with an Emotionally Destructive Spouse

There often comes a time where direct communication needs to happen with your spouse in order to open the door for change.  Vernick suggest templates for how to talk about what you’re willing and not willing to tolerate, emphasizing the need for follow-through on what you commit to do in response to his intolerable behaviors.  She reminds you not to get sucked in to the emotional abuse or manipulation, remaining calm as a way of avoiding destructive dynamics from the past.  She encourages keeping yourself safe as the highest priority, suggesting this confrontation happen in public and with support individuals nearby.  These practical tips help this process feel more manageable.

If you are wondering if you might be in an emotionally abusive or destructive marriage, pick up this book and give it a read.  Do the assessments and follow the action plans.  Learn to communicate clearly and directly with the specific and practical steps Vernick offers.  Open yourself up to explore your own history and how it might be influencing your spouse to your spouse.  My hope is that this will give you the courage you need to take a stand and take up space in your marriage.

The View from the Therapist's Chair: A Review of Maybe You Should Talk To Someone by Lori Gottlieb

There’s an old adage in the therapy world that therapists are best equipped to help others walk through difficult experiences when we’ve done our own therapeutic work. It can seem strange to imagine your therapist getting help, but the truth is that many of us do. And when we do, it makes us better at helping others.

Lori Gottlieb is a psychotherapist who entered the field later in life. While she was a therapist in private practice, she ran into her own personal issues and decided it was time for her to seek out therapy for herself.  This is the story of her parallel process: what she was experiencing in her own therapy and personal life and how those were impacted by what was happening in her sessions with her patients.   

As a therapist myself, this book resonated with me deeply.  In some ways, it felt like my own personal diary.  Hearing her walk through her struggles and describe them in clinical language that is familiar to me from grad school helped me to relate even more deeply to the story.  This book reminded me of things I know but often forget about my field of work and practicing psychotherapy.

At the same time, there were elements that were tough and challenged me as a therapist.  Reading this book helped me humbly reconsider the way I approach therapy and run my sessions.

Whether you are currently in therapy, are considering beginning now, or are a therapist who is hoping to begin your own journey through therapy, I’d recommend taking a glance at this book.  Here are a few of my takeaways.

Good therapists are self-aware enough to seek out their own therapy when needed.

We all go through difficulties in life and moments of grief or trauma, including therapists.  Therapists especially need of extra support because we are holding the pain of the stories of the people we help. 

What therapists learn from their own experiences in therapy informs their work with you.  You can often feel it in how they hold themselves in sessions.  In fact, I recommend you ask your therapist if he or she does their own therapy to find out this fact.

Most of our problems boil down to relationships and connection (or lack thereof) with others.

Think about what you seek out help for in therapy.  How many of those issues are directly or indirectly related to relationships?  The therapeutic relationship becomes essential in healing when you realize this fact. 

Your therapist likely genuinely loves and cares for you.  You share a lot of vulnerable parts of your story with them, which invites intimacy.  I feel that way about my own clients.

The therapeutic relationship also provides a corrective process to “repetition compulsion.” Repetition compulsion involves looking to receive love in the same way you did from parents as a child, even though it may have been abusive or harmful, because that feels normal.  Therapy can teach you that it feels good to be cared for and loved in a healthy way.

Good work in therapy is slower than you might expect.

Patience is a skill that is both developed by participating in psychotherapy and also needs to continue developing as healing happens on its own timeline.  You’ll take many small steps toward health over a long period of time.  Gottlieb says, “A supervisor once likened doing psychotherapy to undergoing physical therapy.  It can be difficult and cause pain, and your condition can worsen before it improves, but if you go consistently and work hard when you’re there, you’ll get the kinks out and function so much better.”  Each of those small steps or transformations has a big impact. 

“Most big transformations come about from the hundreds of tiny, almost imperceptible, steps we take along the way.”

— Lori Gottlieb

Don’t be afraid to show your vulnerabilities.

Gottlieb says that patients often put on their best faces in therapy when what psychotherapists want is to see the real, human parts of who you are.  We want to see what’s not working, and that usually means you’ll have to engage with uncomfortable feelings and face the parts you’re hiding in the process. 

In a story Gottlieb shares about her own therapist, she says that his eyes communicate a clear message to her. “In this room I’m going to see you, and you’ll try to hide, but I’ll still see you and it’s going to be okay when I do.”  This is the essence of a strong therapeutic relationship, and it is what I aim for. 

I expect that there will be resistance in therapy: lying, posturing, hiding parts of yourself.  You’re going to be trying to maintain an illusion, and my goal is to break through it.  It’s okay if you resist this process: it can feel vulnerable and uncomfortable. Recognize the resistance when it comes, and be willing to talk about it.

Acceptance is the key to healing.

This book explores the concept of acceptance in depth.  She learns to accept the fact that she doesn’t always know why she does what she does.  Not everything will end with a neat and tidy bow, because that isn’t realistic.  In therapy, you’ll learn how to recognize and accept feelings, including anger, and what lies underneath those emotions.  You’ll come to understand your resistance, avoidance, and hesitancy.

You’ll learn about how you picked up coping mechanisms to survive when you were younger that may no longer be the best choice for you.  What are you using to protect yourself and avoid reality?  Instead of being afraid and denying these things, accept that they are there and be curious about what they have to teach you.

One pattern I notice in clients is that they beat themselves up for feeling pain when they compare their lives to how difficult others have it around the world.  If you have this thought, realize that it is not fair to you and not fair to your experience of pain to compare like this.  Gottlieb repeats several times in this book that, “There is no hierarchy of pain.”  What you’re facing is what you’re facing, and it’s affecting you differently than it would anyone else.  It’s fruitless to compare it to someone else and come up feeling bad about yourself for hurting.

You are the one doing the work of therapy.

Therapy is about a series of small steps you take to heal.  I, or any other therapist for that matter, can’t do this work for you.  It would actually hurt you if I tried.  I can’t save you – you need to learn to come to your own rescue.  I can’t make choices for you, and you’ll find that I often counter requests for advice with further questions.  Giving advice hurts rather than helps: you need to come to your own decisions. 

This book taught me to be more reflective about what happens in my sessions with my clients and to integrate who they are as a person into what causes distress for them.  When I have a good understanding of who is sitting across from me, I can allow them to do the hard work of therapy and simply gently guide them in the direction.

“Rather than steering people straight to the heart of the problem, we nudge them to arrive there on their own, because the most powerful truths – the ones people take the most seriously – are those they come to, little by little, on their own.”

— Lori Gottlieb

And finally, learn to be kind to yourself.

As Gottlieb reminds us, “Most of what we say to ourselves we’d never say to people we love or care about, like our friends or children.  In therapy, we learn to pay close attention to those voices in our heads so that we can learn a better way to communicate with ourselves.” Practice kindness toward yourself by changing the words you use to speak to yourself into ones you might share with a loved one instead.