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http://dx.doi.org/10.1037/14712-011 Forgiveness and Spirituality in Psychotherapy: A Relational Approach, by E. L. Worthington, Jr. and S. J. Sandage Copyright © 2016 by the American Psychological Association. All rights reserved.

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In a mindfulness meditation on pain and forgiveness, Mueller (1992) wrote, “Forgiveness is the enzyme that makes possible our freedom and libera- tion from family pain and sorrow” (p. 16). He advised being patient and compas- sionate with oneself, even honoring the resistance to forgiving with recognition that pain and unforgiveness can be woven into people’s deepest attachments to family. It can be challenging to let go of such pain and allow those family attach- ments to change because it can feel like a loss of the relationship altogether.

Our approach to forgiveness and relational spirituality in couples and family therapy builds on the constructs and overall model described in previ- ous chapters. Key therapeutic dialectics that can encourage forgiveness and healthy relational spirituality include

77 conflict and interactions promoting intimacy; 77 attachment and differentiation; 77 emotion processing and emotion regulation; 77 hope and humility;

FORGIVENESS IN COUPLES AND FAMILY THERAPY

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77 spiritual dwelling and spiritual seeking; and 77 justice and forgiveness.

In this chapter, we apply our model to both a couples therapy and a family therapy case. First, we identify some key systemic dynamics that are particularly relevant to couples and family therapy (i.e., triangulation, paren- tification, scapegoating, and power and control). Next, we discuss three other aspects of a systems-oriented approach (i.e., differentiated pacing, attention to strengths and systemic functioning, and transitions in the moment). We then describe a couples therapy case of Ann and Thomas, which illustrated both the conceptualization and treatment process. We then describe a family therapy case, centering at first around a 13-year-old adolescent boy with parents from different ethnic backgrounds.

SYSTEMIC DYNAMICS, FORGIVENESS, AND RELATIONAL SPIRITUALITY

Triangulation

A triangle describes relationships when, analogous to a third leg of a stool, a third party serves to temporarily stabilize a dyad. This could be a person who intervenes in a troubled marriage, but more broadly could include impersonal resources (e.g., alcohol) that are used to compensate for something lacking in a relationship between two people. Kerr and Bowen (1988) suggested that relational triangles are ubiquitous. Triangulation is not problematic in and of itself. It depends on the differentiation of the triangulated party and whether that person or resource will nurture dependence and conflict avoidance or help the system further develop greater differentiation. Psychotherapists need to be experts in managing triangulation. This is particularly the case in cou- ples and family therapy. Different members of the system will pull the thera- pist to take sides or otherwise maintain homeostasis (Guerin, Fogarty, Fay, & Kautto, 2010).

Chronic triangulation typically perpetuates problems of unforgiveness by preventing growth in differentiation. In some cases, triangulation may even intensify problems of unforgiveness, such as when a spouse is discovered in an affair or a person turns to substance abuse to deal with family con- flicts. Poorly differentiated triangulation can also impede couples and family therapy. This might occur if a person were in both individual and couples therapy and the individual psychotherapist always sympathized with the client’s marital complaints without even meeting the spouse. A person’s use of God or the sacred can also be a source of unhealthy triangulation (Heiden Rootes, Jankowski, & Sandage, 2010), as we describe in the cases to follow.

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Such cases highlight the importance of psychotherapists being competent to integrate spiritual and religious dynamics into psychotherapy with systemic, differentiated awareness.

Parentification

Children in parentified roles in family systems have been recruited into responsibilities or levels of functioning that are beyond their age or com- petence. This kind of role reversal puts children in an impossible position of trying to compensate for parental limitations. The context is obviously important, and certain sociocultural contexts or situations may make paren- tification necessary for one or more children. But the risks of parentification include a high probability the parentified child will experience (a) anger over the perceived injustice of the role and (b) shame over their inability to fully succeed in a parentified role (Jankowski et al., 2013). Both risks can contribute to unforgiveness.

In some cases, parentification can include aspects of relational spiritual- ity. For example, a child might be somehow come into the role of the “good kid” or the “spiritually sensitive child” who mirrors one or both parents’ spiri- tual commitments. A sibling might fall into the role of the “problem child” or the “heretic” who challenges the family spirituality. In poorly differentiated family systems, these roles can become rigid and lead to resentment.

Scapegoating

Scapegoating is a form of triangulation in which a system channels all anxiety, blame, and shame toward a particular family member. This can sup- port cohesion and forgiveness in the rest of the system at the expense of the scapegoat. Couples or family systems that use scapegoating are also low in differentiation. Therapists who aggressively challenge the scapegoating system may be surprised to find even the scapegoated person resists their interventions.

Chronic scapegoating relies upon unforgiveness to maintain systemic stability. If the scapegoating system is destabilized, which is eventually nec- essary for therapeutic progress, other conflicts will emerge in the system. In some cases, religious communities may contribute to scapegoating if moral prohibitions are especially strong against certain behaviors (e.g., substance use, sex outside marriage, divorce) but lax against other problematic behav- iors or attitudes (e.g., workaholism, judgmentalism, exclusion). Most spiritual or religious traditions include compassion-oriented contemplative streams that emphasize internal attitudes of the heart as even more important than behaviors, which can limit scapegoating.

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Power and Control

All systems need to balance power (i.e., influencing others) with con- trol (i.e., limiting the influence of others; Maddock & Larson, 1995, 2004). Power and control are not good or bad per se. It depends on how they are expressed and balanced. Abusive systems are characterized by certain persons using too much power and allowing too little control to others. Physical or sexual abuse involves, among other things, an overuse of power than crosses boundaries of control. Couples and family therapy clearly requires attention to dynamics of power and control and an assessment of safety risks. The lan- guage of “forgiveness” can be exploited by perpetrators who try to manipulate victims into giving up boundaries or legitimate means of social control. There is some empirical evidence that victims of domestic violence may often con- flate forgiveness and reconciliation, believing that forgiving means one must reconcile with their batterers (Gordon, Burton, & Porter, 2004). One other tragedy of victim–perpetrator cycles is that victims often become perpetra- tors by lacking self-control and learning to use the boundary-crossing coping strategy when frustrated in their own relationships.

Spiritual and religious communities differ greatly in how they approach power and control in couples and family relationships. Therapists must seek to understand how their clients’ communities may view these issues. A term such as boundaries might be extremely foreign in some spiritual or religious communities, whereas other traditions have spiritually integrative books written on the topic of boundaries (Cloud & Townsend, 1992).

COUPLES AND FAMILY THERAPISTS AND SYSTEMIC STANCE

A systemic stance of a therapist includes many dynamics that go beyond this chapter, but it is important to highlight three key issues. These include pacing based on being at once a member of the system and differentiated from it; noting strengths within the system as a whole and individuals and not just pathologies; and considering the transitions clients are moving through and transitional goals clients are moving toward as well, as the realities of the present situation clients are facing. In the following subsections, we describe each one more fully.

Differentiated Pacing

The therapist needs to seek to join the system through effective pacing, yet it is also important to keep one foot outside the system. “One foot in, one foot out” is consistent with a differentiated stance. In terms of our relational

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spirituality model, the therapist needs to dwell with the system before acti- vating a seeking cycle. This is particularly the case when systems are low in differentiation, which means there is a high level of anxiety about seeking new information or perspectives.

In couples and family therapy, differentiated pacing mean the therapist has the important challenge of not siding with a particular member of the system. Safety issues can trump this, but that also involves a concern for the overall system. In this approach, the therapist seeks to attach with all the persons in therapy, but there is also a concern for the system as a whole. Learning to pace or connect with different members of a couple or family sys- tem with their differing personalities and temperaments requires a therapist to be highly flexible and differentiated.

Attention to Strengths and Systemic Functions

A systemic perspective involves noting systemic and individual strengths and not just pathologies. This involves asking questions about the functions of certain patterns and behaviors, even ones that seem destructive or dysfunctional. Such a nonjudgmental stance is consistent with differentiation and intercultural competence. One does not need to agree that certain behavioral choices were adaptive to understand how they fit within the context.

This stance also fits with a systemic prioritization on description and understanding before prescriptive intervention. Some spiritual or religious clients might assume that authority figures will rapidly recommend virtu- ous solutions to problems. However, our approach is consistent with many spiritual and religious wisdom traditions, which value accurate, dialectical understanding and facing deep dilemmas.

Transitions and the Present Moment

Systemic therapy also invites consideration of the transitions being sought and of the present situation clients are facing. A valuable assessment question is always, “Why are these people seeking help now?” Systems are often most malleable to change during life transitions, when attachment templates are activated and there is the possibility of transformation. The anxiety and ambiguity of transitions can sometimes intensify conflicts and forgiveness struggles, yet transitions also hold promise for reworking attach- ment templates.

Therapists need to be sufficiently differentiated to sit at the crossroads of transition with clients without needing to solve every problem. Many spiritual traditions have proverbs, teachings, or narratives about these kinds of liminal or between-state situations (Turner, 1969). Transitions provide

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opportunities for new attachment experiences to foster a more secure base for exploration. But this works only if therapists have worked through their own attachment dynamics.

COUPLES THERAPY CASE STUDY

The following case illustrates the use of our model with a couple. Ann (age 37) and Thomas (age 39) had been married for 15 years and had three children between the ages of 8 and 13. They started couples therapy after feeling “disconnected” for several years and sensing increased conflict in the previous year. Both agreed that they had never really had an extended period of feeling deeply connected in their marriage. During the intake, Ann stated she was “confused about what marriage is for.” Thomas admitted, “I’m not sure I really want to be married anymore.” This immediately brought a look of anxious despair to Ann’s face. She in turn complained that she was “low on his priority list,” referring to Thomas’s busy career as a successful attorney and master of business administration student. She said, “Suddenly he will press me to ‘open up,’ which doesn’t come easy for me. Actually, it feels like ‘emotional assault.’ He gets frustrated and then moves on to something else.” When asked how she coped with this, Ann said, “I try to rely on God and spend time with Him. This is a part of my life I feel I can’t share with Thomas. And honestly, I don’t really want to. God is my refuge.” Thomas countered, “She’s inaccessible. She wants me to be around but treats me like a stranger. She acts ‘spiritual’ but won’t admit she’s rejecting me over and over.”

Four years earlier, they had a marital crisis when Ann discovered Thomas had been having an affair with a coworker. This came during a time he had been depressed after the death of his uncle, a man who had basi- cally been a father to him after his own father died in a car accident when Thomas was 7. After the affair came to light, Thomas seemed remorseful to Ann and asked to be forgiven. They went to a Christian counselor through their church for 6 months, and things seemed to smooth over. But now both felt that they continued to lack the intimacy they wanted from their marriage.

Recently, Thomas started attending a mindfulness meditation class at a Buddhist center. He said he was “trying to figure out what he really believes about God, religion and everything.” Ann experienced this as another betrayal of the beliefs she thought they held in common.

Thomas was African American, and his family moved to Brooklyn from the South when he was 9 to be closer to relatives after his father’s death. His mom worked two jobs, and Thomas managed his autonomy by becoming a high achiever in school. Although Thomas’s mother idealized him, he always

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felt a weight of pressure and anxiety that he had to “do right” and to “be per- fect” to compensate for losses and chronic stress on his family.

Thomas’s mother had the family attending Black Baptist churches throughout his childhood. The first summer they moved to New York after his father died, Thomas asked his uncle if he believed in God and was shocked to hear him reply, “Nah . . . this world is too screwed up for there to be any God on duty.” Thomas pushed this memory away, but anxiety, relational dis- sonance, and doubt had been established in his attachment with the sacred. Thomas described his own relational spirituality as vacillating between trying to “please God” through intense spiritual behaviors and withdrawing from any spiritual practice when starting to feel frustrated, lonely, or “not good enough.”

Ann was Irish American and grew up in a small town on the East Coast. She was the oldest of seven kids and said she had been close with her mom “who was always sad but could never admit it.” She described her dad as “always busy” and not interested in deep conversation. Both of her parents relied on her as a kind of “special confidante” while growing up. Ann’s mother was twice hospitalized for mental illness, but those issues were never discussed in the family, as her mother would simply return as if it had been an extended vacation. Her family had attended a Catholic church. She explained,

Trusting God was said to be an act of faith, but practically speaking I felt God’s presence when I obeyed my parents, went to Mass and prayed, and went to youth group. In practice, I was focused on doing the right thing.

Ann’s family prioritized time together, but they avoided conflicts and difficult issues.

Ann and Thomas met right after college while working for the same large corporation. She liked his emotional intensity, goals, and confidence. He liked her calm pace, generosity, and reliability. Although the families on both sides showed signs of accepting their marriage, there were ongoing prob- lems. Ann’s parents often made thinly veiled derogatory comments about minorities with no acknowledgment that Thomas was African American. Before couples therapy, these comments had gone unchallenged and even largely unacknowledged between Thomas and Ann. Ann, although initially idealizing of African American culture when they met, had grown defensive about diversity issues and preferred to try to take a “color blind” stance.

Parallel issues emerged for Ann in terms of gender. She was a biology major early in college but her father often joked about her science interests and said she would have a “hard time finding a husband and job” with that major. She switched to accounting, but her heart was not in that field. She quickly conceded to staying home with the kids once she and Thomas had their first child while trying to juggle part-time accounting work. Ann did

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not mind the accounting work because she was good at it, but vocation was another place she had “given up” on prioritizing her deepest goals and desires. She came to realize that she had never found an authentic voice in her family of origin or her marriage. Thomas did not think of himself as “sexist,” but he had implicitly accepted a view of women as either passively subordinate or threatening and adversarial. He viewed his mother as a strong woman with lots of personal agency, but he had an undercurrent of resentment for ways she seemed overly identified with his achievements as a way of distancing from her own pain and disappointments.

Case Conceptualization

Ann and Thomas were both intelligent people who cared about their children, were involved in their religious and social communities, and had managed to overcome many challenges individually and as a couple. Their various ongoing challenges, conflicts, and ruptures were like those of many of the couples we work with. From a differentiation-based systems perspective, they were a highly fused couple, which means they lacked emotional bound- aries that enabled genuine connection without the loss of self (Skowron & Schmitt, 2003). This made it difficult to tolerate the anxiety of differences of opinion or conflict and resulted in their felt need to distance and manage life tasks separately. Trying to collaborate was too stressful. So, paradoxically, their underlying fusion led both to use extreme measures of relational control (i.e., limiting the influence of the other; Maddock & Larson, 2004). Each experienced the other’s control moves as rejecting and withholding. Thomas felt that Ann withheld her passion, feelings, and authentic self. Ann felt Thomas withheld his commitment to prioritize her and the kids ahead of his career and other interests. This symmetrical pattern of withholding gener- ated mutual resentment and reinforced the walls between them. Why share your deepest passions and feelings with a husband who is uncommitted? Why commit to a wife who locks her heart away? Their relational dynamics of unforgiveness were perpetuated by this interlocking control standoff.

Boundaries of control are a necessary part of life, but an extreme imbalance of control can represent a self-protective stance that severely limits attachment or intimacy. Control temporarily reduces the anxiety of risking the vulnerabil- ity of revealing one’s real self to the other. But over time, extreme use of con- trol drains vitality, limits growth, and contributes to other problems. Thomas and Ann managed to stay married with so much control and such limited inti- macy through, in part, triangulating other sources of connection and coping. Thomas’s sexual affair was an obvious example of seeking pseudoconnection. But he also seemed to maintain a chronic affair with career success, which he privileged over his marriage and family connections. One might empathize

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with the intergenerational and sociocultural reasons Thomas felt such pres- sure to prioritize his career, and it distracted him from his loneliness and lack of marital satisfaction. One could even admire Thomas’s lifelong pattern of achievement as a coping device to try to compensate for attachment injuries, but he was at a point in his life where his well-patterned coping strategy was not working.

Ann’s triangulation with her projected relationship with God is a less obvious example of maintaining control and compensating for limited inti- macy than is Thomas’s affair. At the content level, the language and idea of “God as refuge” was consistent with Ann’s spiritual tradition. In couples, it is not uncommon for a spouse who feels lonely or betrayed to turn to the sacred in this way for compensatory coping. But a process-oriented assessment of Ann’s relational spirituality reveals several important limitations. First, Ann admitted she had quarantined her relationship with God away from Thomas, thus her marriage was not integrated into her relational spirituality. This reflected her avoidant style of attachment rooted in her family of origin. It meant that she shared little emotional vulnerability and tried to cope with anxiety through distraction and interpersonal distancing. Second, Ann had trouble seeing this at first, but she often used her relational spirituality for a one-up position in her marriage in a way that conveyed judgment of Thomas. The implication Ann conveyed was that Thomas’s workaholism was a “selfish” and “secular” interest, whereas her relationship with God was virtuous. And although Thomas had apologized for the past affair, and Ann had told him she forgave him, they had never tried to understand how the affair happened or work through the deeper attachment injuries involved. This created a paradox in power in the relationship. Ann was often dis empowered in terms of Thomas’s many other commitments and his economic position in the relationship. But Ann had the power of moral superiority. Finally, Ann was quite committed to her relational spirituality. However, she seemed imbalanced toward spiritual dwelling with a low level of differentiation from her family of origin. She had never really engaged in spiritual seeking or sought to make her spirituality “her own.” This meant her spiritual development did not include much integration of tolerating and repairing conflicts, sharing authenticity and intimacy, or confronting issues of social justice and valuing differences.

Thomas’s relational spirituality reflected his ambivalent style of attach- ment. He could be passionate and vulnerable spiritually at times, some- thing Ann had initially found attractive. But he was inconsistent. When distressed, he might pray intensely to God for help but then feel discouraged or even angry when he did not feel God’s response. He would then typi- cally ignore spiritual practice for months until he felt particularly grateful for an achievement or shamed over a setback. His projected God image was

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shaped primarily by his mother, so his relational spirituality was laced with performance anxiety. His uncle’s doubt was also an important experience of relational spirituality that was “split off” or repressed because had been too dissonant or anxiety-provoking to explore. In light of this, his recent move toward mindfulness meditation and Buddhism indicated the start of a spiri- tual seeking cycle with potential for a more differentiated form of relational spirituality. But at the start of therapy, Thomas’s spiritual difference seemed to Ann more like another example of his dangerous lack of fidelity and a new point for her unforgiveness to coalesce.

Couples Therapy Process

Couples therapy with Ann and Thomas progressed in a nonlinear fashion, winding its way toward growth in differentiation, intimacy, and cooperation. The main relational source of gain in this approach to couples therapy involves trying to develop a securely attached and well-differentiated relationship with the couple through dialectically balancing challenge and support. Action-oriented interventions focused on transformed coping strat- egies and relational patterns that gain strength from a healthy therapeutic alliance. We summarize the couples therapy process as iterative movement through the same four interrelated phases described in Chapter 9 on long-term psychotherapy.

Phase 1: Forming an Attachment

The early phase of therapy emphasizes pacing. In pacing a couple, the therapist needs to move rather fluidly between the two partners, seeking to understand and validate the concerns, values, and goals of each person. This involves empathy, but a therapist is also engaged in pacing when trying to line up with a client’s emotional tempo or body posture. This was a challenge for the psychotherapist working with Ann and Thomas. Thomas tended to be emotionally intense and to speak in bursts before slumping back into the couch with a look of exhausted despair. Ann tended to speak in a slow, methodical manner, with limited affect. The therapist needed the moment-by-moment dif- ferentiation to shift the style of interaction in pacing both Ann and Thomas, in turn, while also calming the system with attentive presence.

Couples therapy and family therapy add other levels of complexity with multiple members of the client system in the room, each wondering whether the therapist is “on their side.” In addition to basics of pacing, it is particularly important for the therapist to (a) seek to understand each person’s perspec- tive on the definitions of problems or conflictual patterns, (b) seek to under- stand the wants or goals of each person, and (c) begin to explore what is most important or sacred to each person (i.e., his or her relational spiritualities).

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This involves relating to the couple or family out of a warm curiosity while exploring these questions with the kinds of pacing that can keep anxiety within tolerable limits. Therapists are wise to use clients’ specific language or metaphors to reflect back understanding of their concerns, wants, goals, and values. For example, in the few lines quoted above from Ann and Thomas, the words assault, refuge, stranger, and rejecting were each potentially loaded with meaning and metaphorical significance.

Therapists also need to balance emotional processing and emotional regulation. Compared with therapists doing individual therapy, couples and family therapists often need to intervene more actively to keep emotional processing from resulting in severe conflict and dysregulation within the ses- sion. For example, the therapist needs to try to stop or redirect a hostile or anxiety-laden interaction that is spiraling downward, even inviting each person to emotionally regulate by taking a moment to “take a deep breath” before trying to understand how the interaction got derailed. Emotionally “soft” or vulnerable “softening” interactions involving sadness can be more effectively processed than hostile or anxiously reactive interactions (S. M. Johnson, 2002). Couples therapists who can effectively orchestrate a balance of emotional processing and regulation are more likely to enhance clients’ experience of secure attachment. Couples therapy will start to feel like a safe haven for connection and exploring meaning.

For many couples and families, this early phase of forming an attachment will also involve the dialectical themes of hope and humility we have discussed. This was certainly the case in the early phase of couples therapy with Ann and Thomas. Once the therapist intervened to help each “stay in their own lane” by not interrupting each other or engaging in passive-aggressive gestures (e.g., eye rolling), the interaction slowed down (Sprenkle, Davis, & Lebow, 2009) and they each began to move into a more emotionally vulnerable place where they wondered aloud whether (a) they were simply too defective with too many problems to be capable of a healthy marriage (humility vs. shame dilemma), and (b) it was actually possible to achieve healthy connection and intimacy in marriage or if that is just a sham propagated by psycho therapists and religious communities (hope vs. despair dilemma). Rather than offering superficial reassurance, the therapist offered pacing and empathy related to their questions and a framing of complex hope about moving forward. That is, the couples therapist communicated the developmental frame that couple relationships inevitably reveal people’s limitations and needed growth areas (calling for humility rather than shame) and that it is usually possible to move forward if there is a deep commitment to the work (conditional or complex hope). This stance required the couples therapist to practice a humble hope- fulness, that is, neither promising miraculous solutions nor giving into judg- ment or despair.

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Phase 2: Coconstructing a Developmental Crucible

Schnarch (1991, 1997, 2009) has used the metaphor of a crucible in reference to a severe test that heats up with the anxiety of a core integrity dilemma, and we are highlighting the relational nature of such dilemmas. During this phase, the couples therapist tries to (a) form an attachment with them as a couple; (b) help each, in turn, coconstruct and face a key relational dilemma; and (c) understand the reality that there are no guarantees about outcome.

The therapist helped Thomas clarify his commitment dilemma by fram- ing it like this: Thomas could give up his primary commitment to achieve- ment and validation from others and fully commit to building the kind of marriage he wanted, even though, at the moment, he could not envision how this could possibly happen with Ann. Or he could “push away from the table” without really trying and yet he would never know how that would have turned out. This raised many deeper questions about self-identity, per- sonal values, emptiness behind his confident façade, and difficulty trusting God or himself to move forward in marriage. The therapist allowed Thomas to wander into other topics during sessions but kept seeking to wrap his com- mitment dilemma into the conversation several times each session.

The therapist worked with Ann to coconstruct her dilemma: She needed to decide whether to come out of her spiritual refuge and actually put her heart, feelings, and voice into her relationship with her uncommitted hus- band. Or she could continue to keep her heart behind the fortress walls and see what would happen. The spiritual reflection question became whether she believed God wanted her to keep her heart out of her marriage or put it back into her marriage, which the therapist offered as an honest question. This is a common and understandable dilemma for someone whose partner has enacted infidelity.

Like many couples, Ann and Thomas each had very painful attach- ment experiences earlier in life that contributed to their marital alienation. The therapist offered some psychoeducation about attachment to help both understand their backgrounds and working models of relationship. In control-based cases such as this, in which each partner is afraid of further attachment injuries, unforgiveness reduces the risk that would come with “going all in.” It is important in this phase of therapy to make sure each member of a couple is committed to working on healing and growth in the relationship. The commitment dilemma becomes a valuable existential and spiritual issue involving themes of choice, trust, and integrity. When there has been deep hurt and mistrust in ongoing relationships, such as marriage, the hard work of forgiveness and building a secure attachment will typically require substantial levels of commitment to growth and a willingness to at least attempt possible reconciliation.

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Although Ann and Thomas both valued spirituality, their spiritual worldviews were fairly idealistic. That kept them oscillating between a kind of passive hope for spiritual rescue and feeling ashamed of not living up to spiritual ideals. Yet, their spiritual traditions (Christianity for Ann and a Christian–Buddhist combination for Thomas) did offer teachings suggesting that (a) suffering can be normative rather than shameful and (b) spiritual development and virtue can be cultivated through sustained and intentional practice. The therapist initiated discussion of how their spiritual traditions and commitments might be useful to each of them while continuing to hold up the question of whether they each wanted to commit to the working on their relationship. Eventually, each decided to commit to invest putting their hearts into the work.

Phase 3: Processing Disappointment and Grief

Movement into their personal crucibles also increased anxiety and depressive symptoms for both Thomas and Ann, similar to contemplative descriptions of the “dark night of the soul.” As with most people, they had been hoping for an easier pathway toward healing and intimacy, and it is hard to surrender those idealistic fantasies. This phase is analogous to the spiritual practice of lament, as the painful realities of life are authentically faced and emotions are processed. The therapist used the word disappointed repeatedly with both in pacing their sense of loss and disappointment in their families of origin. Thomas lamented being emotionally neglected and so conditionally loved, which contributed to his intense fear of failure. Ann lamented being expected to deny all unpleasant feelings and discrepant opinions, take care of her parent’s insecurity, and pretend she was not an adult, contributing to her condition of psychospiritual exile. Despite their differing family-of-origin experiences, they both felt underparented in certain ways. They actually began to connect around a shared sense of loss.

The chapter of their story involving Thomas’s sexual affair was particu- larly painful to revisit. Yet, it held important pockets of grief and points of learning for both of them. Thomas faced ways his desire for constant validation had led to the affair and also contributed to the invalidation and unforgiveness in his marriage.

At times, they were disappointed in their couples therapist for not coming up with better solutions, and they were surprised when their thera- pist helped name this. Both found it an unusual relational experience to try to authentically attach to someone (each other and their therapist) while processing emotional challenges and disappointments. They began to develop more secure attachment and differentiation as they learned to sit empathically with one another in their pain without trying to rescue or fix one another.

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The therapist eventually prompted exploration of the realities of racism and sexism. This was a biracial couple with both members operating from intercultural minimization (i.e., dealing with cultural differences by ignoring or minimizing their significance; Hammer, Bennett, & Wiseman, 2003). On the one hand, this common strategy represented a successful assimilation into their overwhelmingly White church, neighborhood, set of friends, and people in Thomas’s profession. On the other hand, it also represented a rela- tional stance of numbness that helped them cope with implicit and explicit racism and sexism but also limited intimacy with one another.

Both Ann and Thomas had major parts of their selves and social identi- ties in exile, which reflected tragic ways they had internalized discrimination and exclusion. They were once incredibly courageous individuals who came together to do something relatively new in human history and definitely novel in their family histories—construct a biracial marriage. But social oppression and their own vulnerabilities had worn them down into fighting with each other with no collaboration in working together against threats outside their marriage.

Grieving their disappointments, including disappointments with God for allowing such suffering, shifted their God images toward a more secure attachment with God. They felt less repressed anger and fear toward God and the sacred. Ann was particularly helped by the integrative and empower- ing realization that she could both connect with God amidst pain and also draw on the spiritual value of justice to advocate for herself or others to limit certain forms of suffering. Thomas became fairly consistent in his practice of Buddhist lovingkindness (metta) meditation, which helped him become more emotionally regulated and less reactive even during periods when he was also processing pain and disappointment. Both had found it hard to pray or meditate for one another for long time. However, each developed an ability to integrate this into their spiritual practice. This helped cultivate more consis- tent forgiveness and compassion. These results are consistent with empirical studies showing partner-focused prayer or meditation can foster forgiveness and cooperative motivation (Lambert, Fincham, DeWall, Pond, & Beach, 2013; Lambert, Fincham, Stillman, Graham, & Beach, 2010).

Phase 4: Cultivating and Extending Differentiation

Initial progress on forgiveness in couples therapy involves reductions in motivations toward revenge and internal avoidance and increases in benevolent motivation. This opens the potential for further work on differ- entiation as expressed in collaboration and deeper intimacy. Differentiation can result from surviving unilateral risk taking and engaging in the humility necessary for collaboration. The couples therapist explored with Thomas and Ann (in the presence of the other) strategic risks they might each take in

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their marriage for the sake of their personal integrity and spiritual formation. In this model, it is important to not broker deals between the two, as that would nurture the couples’ dependence on triangulation and limit secure- base behavior. Their changing forms of relational spirituality were engaged by using the frame that spirituality involves wise and deliberate risk taking.

Ann began to explore risks of passion and voice. She revealed herself at multiple levels. Ann began to speak up for herself in her family of origin, at church, in her workplace, and in her marriage. Thomas also stepped into the risk of setting boundaries with work and career goals, which felt risky to him because he had significant anxiety-driven achievement motivation. They began seeking authentic connection and collaboration in areas such as parenting and finances, even though their exchanges did not always feel great or go the way they each wanted. They started to work together in these areas and initially found it anxiety provoking and frustrating because they were “out of rhythm.” However, they continued to engage spiritual and emotional practices for regulating anxiety.

In the past, one of them might initiate something new (e.g., sexually or in managing finances), and if it did not work the first time, they would usually feel shame, lose hope, and slide back to prior patterns. The therapist nurtured hope and humility by normalizing the challenges of trying new patterns of behavior and suggesting that they use sessions to troubleshoot ways of working with new patterns. This increased the recovery rate of forgiveness following conflicts and prevented deep trenches of resentment and internal avoidance from reemerging.

The therapist promoted and moderated healthy, respectful discussion of differences between the two of them, such as differences of personality, race, ethnicity, gender, and spirituality. Differences had been too anxiety pro- voking in the past for them to engage, with the dark irony that chronically avoiding conflicts over differences had the result of creating severe conflicts and unforgiveness. It was as if they found the differences between them to be so scary at a primal level that the other person was just unforgiveable. The therapist modeled a nonanxious and positive attitude toward exploring and appreciating differences.

Summary

Clearly, not all of the tensions between Thomas and Ann were removed by couples therapy. Yet, within 18 months, each had moved to a more mature and differentiated place, and together, they could relate to each other with- out having to avoid conflict or be unforgiving to keep conflict quarantined. The couples therapist established a successful working alliance with them as a couple and as individuals through pacing and balancing challenge and

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support well to enable the partners a safe haven to wrestle with some very emotion-charged personal issues in their crucible. This initial work on for- giveness enabled them to continue to work toward healthier collaboration with enhanced capacities for dealing with subsequent conflicts.

FAMILY CASE STUDY

The following is a family case that enables us to explore family systems dynamics related to forgiveness and relational spirituality. Andy is a 13-year- old boy who was referred to a psychologist by his school counselor. After miss- ing many days of school over the prior months, Andy seemed to be school phobic. He told the school counselor he had fantasies of shooting kids at school, particularly some Latino boys who had been picking on him recently. He did not seem to have access to weapons, nor did he report an active plan, but the school took this very seriously with his parents and ordered a mental health evaluation.

Andy slumped into the first session with the psychologist. His mother, Anita (age 35; Mexican American), slid her chair close to Andy. His father, Bill (age 44; Swedish American), sat on the other side of the room. Andy initially grunted or answered briefly to questions. He had difficulty making eye contact with the psychologist. Anita often rushed in to answer for him. She explained that he had always been shy and had frequently been picked on by other kids. However, this year, his resistance to going to school had gotten much worse.

She had started working full-time managing a dry cleaning business that fall. Andy seemed to struggle with her being gone more. She had been trying to get time off work to be around for him, but the owner of her business was threatening to replace her. Anita was visibly anxious, and her speech was pressured when she talked about Andy and his recent struggles. She often turned to look at him, twisting nervously in her chair. She said many days she brought him treats because she felt guilty about her work, but he was usually angry at her anyway.

Bill was less obviously nervous and even jovial in tone:

I’m not sure what’s going on, but Andy is a great kid! I’ve been talking with him about getting a paper route or some work in the neighborhood. I was working close to full time when I was his age, and it sure kept me out of trouble.

Andy’s biological father, Reid (German American), was someone Anita dated casually, and he moved away shortly after conception with no interest in fatherhood. Bill had entered the picture around that time and offered Anita a more stable partner for starting a family. They had never told Andy of this.

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Andy and Bill did not spend much time together and did not have much rapport. Bill was working two jobs to try to help make ends meet. His father had died of a heart attack when he was about Andy’s age, and as the oldest of five children he went to work in a grocery store full time. He had spent most of his life working hard.

With his parents out of the room, Andy finally began to offer some information. He said he “hated school and everyone at school.” Kids had always picked on him for being “weird,” but it had gotten much worse this year with racial slurs directed toward him and also about his mom. This teas- ing and racism usually came from a group of “White boys,” but he also had an incident the month before in the locker room where four Latino boys who had been friendly suddenly pushed him into the shower with his clothes on. Andy slipped in the shower and sprained his ankle severely. The gym teacher (also Latino) had intervened and followed up with Andy in ways that sounded supportive, but Andy said, “Something snapped inside me” at that point. The other kids in class saw him sitting with clothes drenched, and he felt humiliated. His temporary hope of finding solidarity with other boys of color was quashed in this perceived rejection.

Spirituality had become an issue of contention in the family system. Andy had started to look into Satanism and to define himself as a Satanist over the past month. He said he wanted “spiritual power over his enemies” and that “God is weak.” This was very upsetting to Anita, who belonged to a United Methodist church in the neighborhood, where she had attended Alcoholics Anonymous meetings when she got sober many years before. She explained,

God saved me from myself . . . my wild life, getting drunk, running around. I owe everything to God. He’s my rock. I know I am failing Him . . . with all these problems we are having. I’m praying harder than I ever have. We need a miracle! But I am so afraid of this Satan stuff Andy is saying. I am scared I will lose his soul and don’t know what to do.

The church congregation was mostly older adults, but Anita attended faithfully on Sundays and a weekly Bible study. Andy had resisted attending any youth group activities for the past year. He stopped attending after the previous youth group leader, Iris, abruptly left her position and seminary studies to go back to help relatives in Haiti following a devastating storm. Andy had liked Iris, had confided in her about his struggles, and was despon- dent at her leaving. When asked if he attended the church, Bill explained, “I work on Sundays. I go with Anita at the holidays. I was raised Lutheran. What’s important is doing the right things and helping others. That’s my religion.”

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Case Conceptualization

This family system was dealing with multiple stressors and conflicts, which resulted in serious crisis. From a systems perspective, Andy had become the “identified patient” who was manifesting intense symptoms of anxiety, anger, and unforgiveness reflective of family and relational dynamics beyond his own individual functioning. Andy certainly needed a psychiatric and psychological evaluation and crisis management to stabilize his symp- toms. However, a broader relational and systemic perspective was also needed to understand the numerous factors influencing this case. The psychologist recommended family therapy.

We can start by noting attachment and differentiation dynamics. Andy and Anita had historically both experienced an anxious ambivalent style of attachment and considerable fusion with one another. Anita was quite com- mitted to her parenting of Andy and concerned about his well-being, but her own ongoing struggles with anxiety and shame led her to overfunctioning for him. She struggled (not very successfully) to set structure or limits. She was often preoccupied with his wants and mood states and tried to soothe him (and her own anxiety) by excessive accommodation. That worked for a time, but was no longer effective. For many youth, the transition into ado- lescence or young adulthood is often when permissive parenting runs into problems because of the teen’s developmental need for increased autonomy and self-regulation. Attachment dynamics become particularly important during developmental transitions. Andy lacked any secure attachment fig- ures. He was wounded by the loss of Iris, who might have provided some support were it not for her quick departure (perceived as abandonment). Bill displayed characteristics of avoidant attachment, which added to the coali- tion between Anita and Andy. Bill had seemingly been parentified around Andy’s age and had to grow up too quickly, and this contributed to his limited ability to help Andy with his own differentiation.

But Andy’s attachment struggles had become more complicated with the recent experiences of bullying and racism, which had reached traumatic levels. He had often been picked on in the past, but now he had reached an age where he was more self-aware of the dynamics of racism and more vulnerable to internalizing shame related to his social and cultural identity. Research literature on both bullying and racism demonstrates the trau- matic impact this can have, and the increased stigmatization and exclusion experienced by kids such as Andy can boil over into violent ideation and rage. For anxious, internalizing kids such as Andy, this move toward exter- nalized aggression is obviously dangerous. However, it can also represent intrapsychic defenses of splitting and projection to stave off self-hatred and self-harm.

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Andy can be viewed as a spiritual seeker through his recent explora- tion of Satanism. His spiritual search seemed primarily driven by anxiety and anger. However, the therapist also believed it could be understood as a quest for justice and spiritual protection. Andy found his mother’s religious com- munity to be disappointing and to lack resources to help him deal with his recent vulnerabilities. To cap it off, the unexpected and unprocessed loss of Iris was an attachment injury. Thus, benevolent forms of relational spirituality had been desecrated for Andy, and his movement toward dark, powerful, and vengeful spirituality (i.e., this version of Satanism) revealed his skepticism about the agency of most authority figures and his honesty about his antisocial feelings and motivations in a family system that hid significant secrets.

The family system also revealed several forms of triangulation. The most important was a rescuer drama triangle (L’Abate, 2009). Bill had played a rescuer role for Anita and Andy. When extreme forms of rescuing form the basis for starting a relationship, there is a temporary stability, which usu- ally erodes into significant conflict, dysfunction, and unforgiveness. Bill had learned a parentified rescuer role in his family of origin, and becoming the rescuer was his main way of attaching. When there was not a crisis, he was not sure how to relate. He tended to withdraw into work or reading. Because Anita felt negative about herself and emotionally cut off from Bill, she felt a need to continue to relate to God as a rescuer and to focus on Andy. One study has found that extreme family triangulation can either inhibit spiritual questing or add such intense anxiety that spiritual questing may become reac- tive among adolescents and emerging adults (Heiden Rootes et al., 2010). The latter had become the case for Andy.

Family Therapy Process

Phase 1: Forming an Attachment

This was a complicated case that required multiple modalities of inter- vention and, therefore, several therapy attachments. Andy first entered a day treatment program to gain some stabilization, learn some anxiety manage- ment skills, and try some medication for his anxiety and mood difficulties. Bill was initially concerned that Andy would not fare well around “a bunch of troubled kids,” but Andy actually responded positively to the well-structured groups and seemed to find some of the alternative community of fellow out- siders he had been seeking.

Perhaps even more important was Andy’s opportunity to work with an individual psychotherapist of color who was highly competent in dealing with sociocultural and spiritual issues. Andy was initially resistant and closed off, but his psychotherapist validated Andy’s desire for justice, protection, and power. This surprised Andy. Over several months, he began to share

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some of the vulnerable experiences of victimization that led to his anger. He had not previously experienced an adult who was sufficiently differentiated to sit with him amid his anxiety and pain. Iris had come close, but he had lost her, and things had turned more traumatic after that. Andy had some impor- tant and sophisticated questions about suffering in life, and his experience had been that authority figures (divine, parental, academic) could not be trusted to help. When a young person experiences an unresolved existential crisis, it is not hard to understand how it might feel absurd to sit in an algebra class. Andy needed a secure attachment to someone who could support the meaning-making process.

The psychotherapist also engaged Andy in discussions about cultural and racial issues. He validated the challenges of being biracial and a boy or man of color, and he exposed Andy to literature by Latino authors. The psycho- therapist’s goals were to help Andy (a) heal from trauma and internalized racism and (b) develop positive cultural identity. Identity work is part of devel- oping differentiation of self. Without this, the self is vulnerable to severe shame and narcissistic injuries resulting in unforgiveness.

Anita and Bill also started meeting with a marriage and family thera- pist, who validated that they were both responsible people who had shown resilience in dealing with many life challenges. The therapist paced their emotions and concerns, and suggested a marital frame of working together to help Bill and Anita further collaborate as marital partners and parents. They both found the humility to acknowledge they could use some help. This dis- sipated some of the shame they had felt about Andy’s struggles. This involved a kind of self-forgiveness.

Phase 2: Coconstructing a Developmental Crucible

In couples therapy, the coconstruction of the developmental crucible unfolded as the couples therapist probed what Bill and Anita each wanted in their relationship and family life. Schnarch (1991, 1997) has pointed out that revealing one’s wants and desires is an act of intimacy and often comes with anxiety that heightens a crucible process. Like many couples in this situation, Anita and Bill each found it easier to talk about (a) their family dynamics over their couple dynamics and (b) what they did not want as opposed to what they did want. The couples therapist continued to pursue their marital wants, and this intensified the emotional process. Eventually, Anita provided the key crucible language construction in blurting out, “I guess we need to decide if we are going to just go on being roommates or have a real marriage.” Both seemed initially shocked and scared to have that out on the table but also felt relieved over the next few sessions to be able to discuss that dilemma as adults. Rather than quickly suggesting a remedy to this, the couples therapist stoked the fire under the crucible by exploring

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how the situation had developed and the possibilities for a different type of attachment.

Important relational spirituality dynamics began to emerge. Bill wanted to spend more time with Anita but did not feel he could compete with her church activities, saying, “That stuff is about her and God . . . and what’s more important than God?” Anita started to see the rescuer dynamics in her relational patterns. She felt “undeserving” of the help she had received from both Bill and God. In the case of Bill, she now admitted she was frustrated that he was often closed off emotionally and prioritized other things over their relationship. She had avoided dealing with her internal feelings about this, explaining, “How can I be upset with someone who works so hard and helps people so much?” The couples therapist began to help each to draw on their deepest values in considering how to approach the partner and the overall marital dilemma differently. They started to experience mutual forgiveness as they found hope for new patterns of interaction and a greater commitment to prioritize their marriage relationship.

Once Andy’s mental health started to stabilize, they started work with a family therapist who collaborated with the couples therapist and Andy’s individual therapist. Anita and Bill had already come to the conclusion they needed to tell Andy the truth—that his biological father was Reid. Privately, they asked the family therapist for help and processed this disclosure during a session. It is not surprising that Andy had a range of reactions, including anger at being deceived for so many years. Anita apologized but had difficulty for several weeks dealing with shame over the issues. However, a major turn- ing point came with Anita finding the differentiated stance to empathize with Andy’s feelings and offer validation but also insisting that it was not accept- able to keep calling her derogatory names. When their family therapist noted this change and wondered about it, Anita explained that she had received a picture in her mind from the Holy Spirit during a recent worship service and could see herself being both strong and merciful with Andy. She said she had never had an experience like that before. However, in that moment, her anxiety about working through this particular issue “faded away.” The fact that this experience overlapped with the therapist encouraging Anita to deal with parenting dynamics raises interesting possibilities about the unconscious integration of psychology and spirituality.

Andy’s identification with Satanism also waned as his mental health and attachments improved. The family therapist was able to help the family work at skills in accepting differences and managing their anxiety in the moment when different views arose. This enabled each to begin to voice some questions or perspectives on various issues, including spirituality, and this improved spiritual differentiation lowered the reactivity and conflict in the system. Anita and Bill came to appreciate that, beneath his flirtations

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with Satanism, Andy’s spiritual anger was largely due to injustice and victim- ization. Both were helped when Anita observed that this anger was like the prophets in the Bible. An important relational spiritual process was Bill and Anita communicating solidarity with Andy in outrage over the racism he had been experiencing. About a year into the family therapy process, they began visiting various churches together with the intention of finding one that could fit for all of them.

Phase 3: Processing Disappointment and Grief

As things started to improve in the nuclear family system, it provided the security to begin to process various points of disappointment and grief. Andy had sadness about Reid not being part of his life, and the family thera- pist helped Bill to connect with Andy about this, rather than take it person- ally. They had both lost their biological fathers. The therapist also teased out their differing defaults on coping with sadness. For Andy, sadness typically morphed into anger and avoidance of everyday life whereas Bill tended to pour himself into work. This differentiation work further softened the reactivity of unforgiveness.

Anita and Bill used couples sessions to process family-of-origin issues. Their increased security of attachment and improved family relations paved the way for the couples therapist to explore what they had missed out on in their families of origin. In this way, forgiveness work turned intergenera- tional as each worked to make narrative sense out of their parents’ struggles. With the therapist modeling a caring and calm approach to unpacking dif- ficult events and emotions, Bill and Anita were scaffolded into learning to attach and help relationally regulate emotions as they did this grief work together. Bill eventually realized being fully engaged as a father brought him in touch with unprocessed grief about the tragic loss of his own father, which opened him to deeper spiritual seeking and moving past a foreclosed relational spirituality based on his parentified family role.

Phase 4: Cultivating and Extending Differentiation

It would be hard to summarize all the areas of therapeutic work this family did over a 3-year period. This fourth phase of the therapy process involved further cultivation and extension of differentiated relating in the family sys- tem. Andy transferred to a different school the following year, one that had a strong antibullying program and more therapeutic supports. Anita and Bill were more proactive—an important sign of differentiation—in making efforts to help Andy connect with the school psychologist and several short-term groups for social skills development while also continuing in therapy. Bill stayed engaged with the family. Although finances were tight, Bill was able

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to pull back from some extra work shifts in order to be more present to Anita and Andy. This allowed Anita space to work on developing herself (including starting college) and not feel as tempted to overfunction in their family life. The family continued to struggle with challenges and bouts of reactivity, but their move to more secure attachments and differentiated functioning short- ened their recovery time following setbacks.

This case reveals ways in which chronic avoidance-based unforgiveness contributes to weakened attachments and the risk for a counterbalancing rage crisis. The treatment shows that these could be restored and sometimes averted through relationally informed psychological and spiritual interventions.

SUMMARY

Complexity increases within couples and family therapy. However, the basic processes are the same: forming an alliance, coconstructing a devel- opmental crucible, processing the grief and disappointment that arise from change (and therefore loss), and promoting differentiation. All of these strate- gic objectives take place using a general relational plan: connect and provide a secure base, help the clients explore the issues and tolerate differences, plan and carry out actions, and then process the results.

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