Full Course Description

Clinical Demonstration/Analysis of Terry Real’s Relational Life Therapy (RLT)

Program Information

Target Audience

Psychologists, Counselors, Social Workers, Case Managers, Addiction Counselors, Marriage & Family Therapists, Nurses, and other Mental Health Professionals

Objectives

Session 1: Intro to RLT

Recognize the role of the therapist in Relational Life Therapy (RLT) and how it differs from that role in most couples therapy approaches.

Session 2: Demo & Analysis, Part 1

Summarize the distinguishing characteristics of the therapeutic alliance in RLT and detail the steps for achieving it.

Session 3: Demo & Analysis, Part 2

Differentiate the 3 inner parts of a client’s psyche that RLT recognizes and explain how to work with each to help clients move from first consciousness to second consciousness.

Session 4: Follow-up Interview with Couple

Compare which of the therapist’s actions that are critical to positive outcomes in couples therapy.

Outline

SESSION 1: Introduction to Terry Real’s Relational Life Therapy (RLT) Approach to Working with Couples on the Brink.
Terry Real LICSW and Richard Simon PhD

RLT is a unique approach to couples work
RLT creates palpable change in the partners’ interactions and/or a shift in their emotional fields in a short time-in the case of the clinical demo, a single intensive session.

A major difference between RLT and other approaches is the role of the therapist.
The RLT therapist is an activist, advocate, and coach-not neutral

Is confrontational, directive, and disclosing as needed
Takes sides to gain leverage for change
Takes sides with the latent, power-under partner when necessary-especially when there’s a blatant, grandiose, power-over partner
Speaks from his or her own experience
Educates the functional adult part of the client
Shifts from one therapeutic role to another as needed
Practices therapeutic intimacy-helping clients move into relationality by being relational with them

The RLT concept of stance-stance-dance
The stance or strategies of each partner combine to make up the dysfunctional dance. When the stance shifts, the dance shifts too.

Shifting the stance occurs during the 3 phases of RLT:

Waking up, joining through the truth
Inner child work, re-parenting the wounded self
Learning connection, teaching relationality

The 5 most common losing strategies/stances presented by partners in RLT are:

Being right
Controlling your partner
Unbridled self-expression
Retaliation
Withdrawal

Joining through the truth, a core practice of RLT, jumpstarts the therapeutic alliance. The RLT therapist begins by telling a client the difficult truths about him or herself early in the process. Presented in the context of You’re a good person whose done some bad things, the therapist is able to shape the strategic alliance against, not a person, but the potential loss the client will experience if the marriage fails or the ongoing misery if they continue without making major changes. During the information-gathering phase, the therapist looks for points of leverage to form this alliance.

The Key Steps for Joining through Truth

Therapist forms an alliance with the functional adult part of the Client-a coalition against continued misery or looming loss
Therapist creates cleavage between “I” of client and whatever trait keeps client locked in a dysfunctional stance:
- Grandiosity
- Contempt
- Perfectionism
- Black & white thinking
- Rigidity
- Judgmentalism
Therapist appeals to the functional adult: You are a decent person who’s been behaving indecently

3 goals of joining through the truth

Create cleavage between “I” of client and grandiosity by amplifying negative consequences of actions

Identify and amplify partner’s best self: You are a decent person who’s been behaving indecently
Help client develop an allergy to his own grandiosity or specific dysfunctional behavior

RLT focuses on 3 parts of the client’s psyche

Wounded child
Adaptive child
Functional adult

It is the knee-jerk reactions of the adaptive child which, when triggered, cause most of the problems in relationships. During the internal, individual work with a partner, the wounded child is recognized and re-parenting begins. The ultimate goal of the RLT process is to empower the functional adult to

Choose to change
Move from the adaptive child’s rigid, harsh, first consciousness to a more nuanced, realistic, warm and flexible second consciousness
Learn new strategies and behaviors to replace those of the adaptive child
Re-parent the wounded child-work that begins in the intensive session and continues as needed outside the clinical setting

To assess which part of the client’s psyche is at work, use these characteristics:
Adaptive child is:

Black & White
Perfectionistic
Relentless
Rigid
Harsh
Hard
Certain
Tight in body

Functional adult is:

Nuanced
Realistic
Forgiving
Flexible
Warm
Yielding
Humble
Relaxed in body

Waking up phase of RLT
Early in the process, the therapist works to wake the client up to the damage his or her adaptive child behavior causes in the relationship and also what the partner stands to lose if there’s no change. Primary RLT approaches for this phase are:

Data gathering including reports from both partners and therapist’s own observation
Joining through truth

Individual inner child work in RLT
RLT is unique in integrating this kind of internal, individual work with couples work. According to Terry Real, the best way to open a partner’s heart and stir compassion is for him or her to see the other partner engaged in deep, often painful work.

The focus of the inner child work is RLT is single-minded: identify the childhood wounds that led to the adaptive child behaviors. Once that is done, the therapist moves on to ask the functional adult to begin re-parenting the wounded child. The goal is to empower the functional adult to step in and be a parent to the wounded child whenever that’s called for.

Teaching relationality
Fully 1/3 of the RLT process is teaching and reinforcing new skills and behaviors. Once the therapist forms an alliance with the functional adult part of the client, there is a shift from first consciousness (adaptive child behaviors) to second consciousness (functional adult) and the client is free to learn new behaviors and strategies for living relationally

Couples can learn to be happy
These are some of the behaviors RLT teaches couples to practice

Positive communication
- Respond to positive aspects of message
- Meet positive with positive
- Meet negative with neutrality
Cherishing behaviors
- Generosity (appreciation)
- Fun
- Sex
- Mutual growth

SESSION 2: Last chance for Nancy and Dan: Clinical Demo/Analysis, Part 1
Clinical Demonstration: Terry Real and Nancy and Dan in an intensive couples session. Analysis by Terry Real LICSW and Richard Simon PhD

THE RLT DATA GATHERING PROCESS ILLUSTRATED BY CLIP 1

Keep it positive. Terry Real focuses on hope not the problem: What do you want if we have success today?
Gather Data. Listen to their stories. Watch their behavior. Trust your own feelings. In this case Nancy and Dan agree on the problem
Taking the temperature of the relationship. Terry takes a position “You love her; you love him.” Dan says yes, Nancy says no. Terry recalibrates and focuses on Nancy. This goes on throughout the data gathering. The therapist asserts, sees what the response is. Terry dances with the answer; recalibrates if necessary.
Block and redirect. Excellent example of this strategy: when Nancy says “I don’t know how to be tender and gentle,” Terry calls her out. “Oh yes you do. I saw you do it with him just now.” (amplifying the good.)

IDENTIFYING THE PROBLEM ILLUSTRATED STEP BY STEP IN CLIP 2
This is the exploration of stance, stance, dance. Terry uses a mix of empathy and non-neutral tactics:

Summarizing their 2 ways of way of interacting-fighting or cold, withdrawn mode
Asking for details from each of them
Summarizing again: Sounds like you’re in a loop-you’re both passive-aggressive to each other, punishing, withholding…constipated ragers.
Translates their behavior, in an empathic tone that amplifies their pain as follows: You don’t feel loved or cared about and when that happens you do that to your partner.

The partners agreed that they are involved in the losing strategy of retaliation. The challenge is to get this couple to change their pattern. Terry Real points out that this is a symmetrical couple-there’s not a blatant and a latent-a more common situation in RLT.

When you have two blatants, you get your leverage from dealing with their misery. Notice how Terry does this: first he amplifies their feelings of hurt in an empathic tone. He then shifts to a more directive tone to reframe the situation and amplify the cost of their behavior: You are good people stuck in a bad pattern. And this pattern will eat all the emotion and the good stuff out of your marriage.

Terry then reframes their stories so they understand that they are both victims and perpetrators. Terry points out that the therapist must use precise language when reframing. The goal is to get client agreement: You really nailed it.

Discomfort is the beginning of the leverage for change.
Both partners feel the cost of the dance and feel bad about it All 3-the therapist and both partners-acknowledge the same problem-It’s you two and me against the dance. That’s when the clients “wake up” and join the therapeutic alliance.

BUILDING A THERAPEUTIC ALLIANCE FOR CHANGE IN CLIP 3
Once each partner understands the part he or she plays in the destructive pattern and exactly what they stand to lose if the marriage ends, RLT moves on to deal with affect and emotion through deep internal experiential work. In this clip, Terry Real works individually with Dan in the presence of Nancy. This creates opportunities for Nancy’s open-hearted response to Dan and it reveals Dan as an extremely sensitive, feeling man who can talk about his feelings-something Nancy had come to hold as impossible in their relationship.

Notice the steps Terry follows to secure the therapeutic alliance with Dan.

Therapist identifies and speaks to the “nice person” whose been acting badly in the marriage.
Therapist invites: Will you let me extricate the real you from this mess you’re in the middle of?
Client accepts that invitation

SESSION 3: Fueling Compassion, Empowering the Functional Adult: Clinical Demo/Analysis, Part 2
Continued: Terry Real and Nancy and Dan in an intensive couples session. Analysis by Terry Real LICSW and Richard Simon PhD

MOVING FROM COMPLAINT TO VULNERABILITY IN CLIP 4
Getting partners to understand they are both victims and perpetrators. Dan admits to the fact that he walks on eggshells because Nancy is critical. She agrees that she is critical. Then Terry asks Dan if he says nice things to Nancy. Dan responds with a short, lame list. Terry amplifies Dan’s shortcomings in this area, pointing out that he hurts Nancy by withholding.

Data gathering: partners often use their problem behaviors in the session. : In the first 5 minutes of clip, Nancy illustrates her dysfunctional behavior. She tells a story about Dan following through on something she asked him to do. She immediately undercuts with criticism that he didn’t do more-a perfect example of her critical, complaining behavior with Dan.

Begin joining through truth with Nancy
Terry asks Nancy where this behavior comes from. Nancy traces it back to her family of origin-describing a common experience from her childhood-Even when I was doing something right, I wasn’t doing it right.

In the analysis, Terry points out that identifying the roots of her critical, complaining behavior is where Nancy begins to see some light between herself and her complaint stance. Terry moves into education, offering Nancy “request” as an alternative to complaint. He empathically addresses her concern that she might get hurt.
Notice how, throughout this clip, Terry Real seamlessly switches affect:

Empathic. TR to Dan, Go ahead and feel that
Challenging. TR to Nancy, Did you ask him to call you?
Instructive. TR to Nancy, That’s called the Cinderella Syndrome and Cinderella is dead….
Directive. TR to Nancy, Let me talk to you about complaint. You’re parked in complaint…That’s your relational stance-complaint. The thing about complaint is there’s no vulnerability.
Empathic. TR to Nancy, Make a request and you’re vulnerable. You might get hurt…. but it’s sustainable hurt…

ACCESSING THE INNER CHILD ILLUSTRATED IN CLIP 5
The focus on family of origin work in RLT is identifying the roots of dysfunctional behavior. Once Nancy has traced her behavior to her mother, Terry segues to inner work and invites her to do some experiential work with her wounded child. This almost immediately taps into an emotional place and Nancy cries. Terry empathizes and amplifies her emotion. Terry follows up by helping Nancy practice re-parenting her wounded, abandoned child with her functional adult part.

The benefit of doing deep individual work in the presence of a partner as a shortcut to compassion and understanding.
This is illustrated at the end of this clip when Terry says to Nancy: Now open your eyes I have something to show you. What Nancy sees is the compassion in her husband’s face and his tears for her experience. Terry encourages him to express his feelings in words.

CONNECTING WITH OPEN HEARTS STEP BY STEP IN CLIP 6
Now that both partners have responded compassionately to their partners, Terry Real moves into a send-off that affirms the compassionate opening both have experienced.

Notice how Terry has the partners turn their chairs to face each other. In the analysis, Terry points out that the common enemy in relationships like these is “more of the same.” He goes on to point out that they are now seated in their functional adult selves-not their adaptive child parts. They have had an experience in this session of what it feels like to interact relationally. Ongoing work with an RLT therapist will help them stay on track and make this their new normal.

SESSION 4: Nancy and Dan 9 Months Later: Follow-up Interview with Richard Simon PhD
This 45-minute follow-up session offers a unique perspective on the impact and effectiveness of RLT.

Notice how the session clarified their problem for both partners

Nancy reported that she didn’t realize how desperate she was until Terry asked her what would success for the session look like?
Neither partner realized how angry they were until the session:
- Dan’s withdrawal and withholding was fueled by hurt and anger
- Nan’s complaint stance was fueled by fear and anger
- According to Nancy the turning point for her was when Terry pushed Dan to say he was angry. That was a first, according to Nancy and it was both scary and reassuring. Nancy reported that Dan would say he didn’t like this and that, but he’d never admit to anger.

Notice how both partners responded to Terry Real’s tone of voice and different approaches

Nancy reports a real shift when she experienced Terry being empathic first with her and then with her husband. She realized that was how she needed to be with her husband-empathic
Dan reports that Terry’s demeanor-both empathetic and incisive was compelling to him
Dan also valued Terry’s incisiveness: …like he was doing an autopsy on the dead relationship. He figured out the core thing…this sort of ongoing pattern.
In analyzing the dance and their 2 stances, Terry identifies Dan and Nancy as equally passive-aggressive constipated ragers. According to Dan, Terry got it right.
Terry tells you about hard things in a way that they can hear. He does this with an empathic tone.
Dan reports that one question from Terry really moved him: If those tears could talk, what would they say?

Notice how both partners experienced new levels of understanding and compassion for each other in the session

Nancy knew about Dan’s uncle, but hearing him talk about the relationship was the first time she understood Uncle John’s importance and emotional impact for Dan
As Dan began to show up emotionally in his internal work, Nancy visibly softened and turned to him. His work released compassion in Nancy
Nancy reports: Doing my own internal healing in front of Dan allowed him to understand me. Now (in the last 9 months) Dan understands who gets triggered when his wife gets triggered and he can say-oh I triggered you. Now I feel safe.
When Terry made Nan look at Dan crying, Dan reports feeling great because he knew his wife could see him as an empathic person.

Notice how the partners maintained their gains in the 9 months following the session

Dan: We began the practice of cherishing each other.
Dan: I felt sort of “imperfectly perfect” so the dance was between accepting imperfection and fighting it a little.
They report being euphoric for a while. They had been making it too hard for so long. Nan: I just didn’t want to go back.
They reported hitting some bumps, then taking a break and doing real forgiveness. We were shocked that we actually got through it.
Every time we hit a bump we’re able to resolve it more easily.
We’re happy and that makes it easier.
If we treat each other well we keep feeling good.

Terry Real’s Relational Life Therapy In Action

Program Information

Target Audience

Psychologists, Counselors, Social Workers, Case Managers, Addiction Counselors, Marriage & Family Therapists, Nurses, and other Mental Health Professionals

Objectives

Summarize the impact of RLT on clients' therapeutic experience, particularly the therapists tone of voice and stance.

Outline

Get the big picture of Relational Life Therapy (RLT)
Track the flow of a clinical session using RLT
Attend to how Terry Real makes clinical decisions in real time
- “Braking for affect”
- Amplifying emotion
- Pursuing openings as they arise
- Being flexible (working with Dan’s Uncle John instead of pressing to find a wounded child).

Answering Your Questions about RLT: Audio Q&A

Program Information

Target Audience

Psychologists, Counselors, Social Workers, Case Managers, Addiction Counselors, Marriage & Family Therapists, Nurses, and other Mental Health Professionals

Objectives

Explain the importance of and the process for articulating a problem that everyone-therapist and both partners-can agree on.

Outline

Terry Real answers your questions.
Intro to call
Questions about the RLT process
Summary of Call

Bonus! Couples Therapy: Advances and Challenges in Couples Therapy Today

Program Information

Target Audience

Psychologists, Counselors, Social Workers, Addiction Counselors, Marriage & Family Therapists, Nurses and other Mental Health Professionals

Objectives

Outline the new rules for treating millennial couples.
Describe how we are confronting the limits of couple therapy.

Outline

Overview of speaker’s and their topics

David Schnarch, Ph.D. with “What I’ve Learned from my Treatment Failures”
Pat Love, Ed.D. with “Relationships 2.0”
Helen LaKelly Hunt, Ph.D., and Harville Hendrix, Ph.D. with “Practicing Zero Negativity”
Terry Real, LICSW with “Relational Reckoning”