The parental relationship is potentially the largest factor determining outcomes for children who have two parents, and yet it is rarely prioritized in child development work. Children are identified as the "identified patient" because of at-risk status, qualifying adverse childhood experiences (ACEs), or acting-out behavior, while little is done to assess the functioning of the parent's relationship. Modern psychobiological methods to shift the quality of the relationship are available and must be employed.
Parents with insecure attachment from their childhood experience, a life history with traumatic events, and poor emotional regulation are likely to have less time and energy for parenting, as that energy is used up by conflict or self-soothing. A securely functioning parental relationship provides a "roof" for the child's developmental experience. The challenge is moving a couple from insecure functioning to secure functioning through therapeutic interventions.
Logistically this work is done in an office setting, with two therapists, the couple, and without the children. Expenses are training therapists, paying therapists, office with video equipment, and sometimes childcare.
Effective couple therapy is based on leveraging the pro-social bonding "circuits" in the mind to help the couple be secure in the relationship. Specifics interventions educate about perceptions of abandonment, rejection, and neglect (triggers), and adaptive self-soothing and relational soothing. Video playback is used to demonstrate to the couple how their body posture, tone, gaze direction, and other non-verbal communication elicit an escalation.
In the course of therapy the couple learns to negotiate the disruptions caused by historical vulnerabilities to perceptions of abandonment, adaptively self-soothe, and also the value and practice of regulating the other partner. Couples practice "reunion" and "repair" and other small interventions that can turn the emotional tone of a household from cold and tense to warm and safe.
This work is an adaptation of Dr. Stan Tatkin's PACT (Psychobiological Approach to Couple Therapy), Dr. Ingeborg Bosch' PRI (Past Reality Integration) and Gestalt methods.