From Carson, D.K., & Casado-Kehoe, M. (2011).

Case studies in couple therapy: Theory-

based approaches. New York: Routledge/Taylor & Francis.

Imago Relationship Therapy

by Harville Hendrix, Ph.D. and Mo Therese Hannah, Ph.D.

Introduction

Imago (the Latin word for image) is an integrative and systematic theory of intimate

partnership and a unified, theory based therapy for couples. Its perspective, based in part on a

diverse collection of psychological theories, also borrows ideas from more distant fields like

cosmology, quantum physics, philosophy, Eastern thought, and Western religious traditions. A

full overview of the theory is beyond the score of this chapter; here, we'll discuss only those

aspects necessary for the reader to understand how we approach couples, what we do to help

them, and why.

At the most abstract level, Imago theory points to consciousness as the essential

ingredient of all that exists. Human beings and their relationships conform to the same

principles driving everything else in the universe. That is, human beings, like everything else, are

an expression of cosmic energy, an energy whose defining feature is consciousness. At our core

we are, each and every one of us, a magnificent speck of a magnificent universe; we are made of

the same stuff that forms everything else in the universe.

Consistent with this position, Imago's anthropology views interconnectedness as the

essential condition of human beings as well as everything else that exists. This means that we

are interconnected at every level, both within (mind-body unity) and without, with all aspects of

ourselves and all aspects of nature, including all other human beings.
 These same guiding features of consciousness and interconnectedness serve as the

foundation of Imago's psychological theory. Since interconnectedness is the defining feature of

human nature (and all nature), the perceived loss of connection is the source of all human

problems. Although we cannot, in actuality, separate ourselves from the universal web of

existence, we alone (among other sentient beings) can lose our awareness of our essential

interconnectedness. This tragic sense of loss is the universal experience of childhood at the hands

of unempathic and unattuned parenting and its ghost haunts the halls of adulthood. When

awareness of connection is lost in childhood, our survival-oriented psyche aims to restore our

lost sense of connection. This illusory sense of disconnection experienced as separateness,

threat, and alienation shows up most dramatically in adult romantic partnerships. The trauma of

childhood becomes the drama of marriage. All interpersonal behavior, therefore, whether

adaptive or maladaptive, is seen as motivated toward creating, maintaining, or restoring

connection.

For Imago, then, intimate partnership is one more reflection of nature's overriding

purpose for all its creation: to repair what is broken and to make all things whole again. For

human beings, this means that the unconscious purpose of intimate partnership is to finish

childhood. Finishing childhood means two things: healing and growing. To heal, we must

experience, in our relationship with our partner, a fulfillment of our unmet childhood needs. But

this has to occur with a person who reminds us of our caretakers, that is, an Imago match. When

our childhood needs are met by the person who is the closest facsimile to our childhood

caretaker--our intimate partner—our wounds are healed. This process, however, is complicated

by the fact that each partner mirrors the deficiencies of the other’s caretakers and is thus ill-

equipped to provide nurturing for their partner. Therefore, the partners must develop the
undeveloped parts of themselves by stretching into new, uncomfortable behaviors. This

stretching helps each partner grow, that is, to complete the passage through the developmental

stages to achieve psycho-emotional adulthood.

Childhood wounds are the psycho-emotional fallout of connectional rupture. Like any

other wound, childhood wounds are painful, and like physical pain, the pain of childhood

wounds makes us want to protect ourselves against further pain. This, in turn, results in a sense

of alienation between ourselves and our context. Imago clinical theory states the principles

that ultimately form the interventions used by Imago therapists. Each Imago Therapy process is

constructed to produce the essential ingredients of intimacy, of which, we believe, there are four:

1. Becoming present to your partner: This requires a transformation of consciousness in

which one discovers the “otherness” of the partner, in which we get that “my partner is not me,”

which promotes progress toward the important developmental leap known as differentiation..

2. Learning a new way to talk, that is, turning the conversation from an exchange of

parallel monologues into a dialogue. Dialogue creates equality, safety, and connection.

3. Replacing judgment—the destroyer of intimacy—with curiosity, which insures safety

and deepens connection, This requires eliminating all negativity, since negativity stimulates

anxiety, signals danger, and thus activates defensiveness, perhaps the major barrier to intimacy.

4. Infusing the relationship with positive feelings, such as liking, appreciation,

admiration, acceptance, and similar emotions. These deliberate positive verbal expressions

(appreciations) are among the building blocks of authentic love, which is, for Imago, the

consummation of intimate partnership and the epitome of a relationship that is both safe and

passionate, comfortable and exciting.

 In the Imago Therapy process, we see giving and receiving as an oscillation between

polarities that needs to be kept in balance. Paradoxically, most partners complain because they

are not receiving the love they want, but at the same time, they are not giving the love their

partner wants. So the first swing of the polarity is mutually to stretch into meeting each other’s

needs, to move from victim to being a healing resource for each other. This stretching heals and

evokes growth. However, this shift towards giving creates anxiety in each partner, evoking a

defense against receiving the love they want. This defense is rooted in the pain of ruptured

intimacy between caretaker and child, a pain housed in implicit memory. It is unconsciously

reactivated in adult intimate relationships to prevent the recurrence of that pain. To move this

pain from implicit to explicit memory, to transform what seems eternally present into an obvious

relic from the past, one must stretch to receive the love offered, hold it in consciousness, tolerate

the anxiety until it recedes, and then integrate it into consciousness and the self, thus achieving

growth towards wholeness. Due perhaps to a cultural bias against receiving (as opposed to

giving), receiving love seems more challenging than giving it. Therefore, therapists often

overlook receiving love as an essential side of the dynamic balance of giving and receiving.

In summary, for Imago, whenever a couple gets angry at each other and views the other

as the enemy, it can be tied to a much earlier rupture when we, as children, weren't seen for who

we were, weren't noticed, understood, or even loved. This rupture, in order to close, needs the

combined work and determination of both partners; if they are going to grow up as individuals,

they need to do so as a couple. They were wounded in relationship; their relationship, therefore,

is what they need to heal.

Romantic relationship is a developmental process made up of three stages: the romantic

phase, the power struggle, and conscious partnership. The positive projections of the romantic
stage are inevitably followed by the negative projections of the second stage, the power struggle.

The power struggle is launched when 1) partners’ childhood wounds, defenses, and character

flaws cause frustration for the other; 2) instead of spontaneous feelings of romantic love, partners

grow increasingly frustrated with and negative toward each other; 3) when frustrated with each

other, partners use the unconscious and automatic defensive strategies, or defensive adaptations,

that they developed in childhood; and 4) partners use negativity or other forms of coercion to get

their needs met by their partner. During the power struggle, partners unconsciously re-

experience and react to each other in the same ways they did toward their imperfectly attuned

caretakers during childhood.

Clinical Practice Clinical practice focuses on helping couples change the structure of

and content of their conversation from parallel monologue to intentional dialogue. Dialogue

creates equality and safety, thus allowing partners to relax their defenses, authentically engage in

conversation, and ultimately transform their relationship into a process for creating healing and

wholeness, thus enabling each individual partner to finish childhood as they collaborate in

improving their relationship.

Along with generating the essential ingredients of a conscious relationship-- safety and

passion--the entire array of Imago interventions revolve around the five steps designed to lead

struggles out of the power struggle and into the third relationship stage, conscious partnership.

These five steps include re-commitment, re-imaging, removing all negativity from the

relationship, re-romanticizing, and re-visioning.

Case Presentation

Presenting Issues and Difficulties: Married for 14 years, Rick and Denise match the

prototype of the highly educated, high-earning, childless (by choice) "Yuppie" couple, the latter
fact, perhaps, accounting for their strikingly youthful demeanor. Although both are approaching

40, they could be mistaken for still-youthful 30-year olds. There clearly is no shortage of

intelligence between them; both are engineers working for the same large corporations as

managers, although in different departments. A distinct minority in her male-dominated

workplace, Denise has a bachelor's degree in engineering and a master's in business

administration; Rick, for his part, holds a master's in engineering and has completed some

coursework toward a doctorate that, as he puts it, "will probably never happen."

A therapist might wonder, at first glance, what these friendly, easygoing partners are

doing in the office of a couples therapists. As you listen to their exchanges, they seem less

conflicted and distressed than most couples who seek out Imago Therapy. They report that they

"almost never fight"; to the contrary, they "get along great" in almost all aspects of their lives--

their finances, household chores, and other daily routines. Their "only" problem, as Rick puts it,

is their sex life, which is (and has been for several years), "pretty much non-existent." When

Rick brings up their lack of sexual intimacy, Denise becomes, from all appearances, very

uncomfortable; she averts her eyes away from Rick, glancing occasionally at the therapist, as if

begging for mercy. She clearly does not want to discuss it.

Critical Background Information: Imago places less emphasis on the historical factors

of the relationship (e.g., critical events, the birth of children, previous marriages etc.) than other

approaches, especially those with a systems orientation. Within this framework, the "what," or

the details of the partners' lives, the chronology of their relationship, and their particular

presenting problem are of less importance than the "how," that is, how they respond to each other

when the inevitable disappointments and disillusionments involved in living with another person

comes to the fore. Therefore, the focus of clinical attention is not so much on what happened to
or between the partners in the past as on their current interactive patterns--on what goes on in the

space between them (the in-between). Specifically, Imago's therapeutic processes target how

partners think, feel, and behave when they come face to face with the "otherness of the other," at

those moments when they are forced to recognize that "my partner isn't me."

Still, therapists are trained to hone in on certain aspects of history, for instance, the

partners' wounding history, the types of nurturing deficits they suffered, and the defensive

adaptations or coping strategies they learned to use as a result. A second piece of important data

relates to the extent to which partners are re-experiencing, in this relationship, their relationship

with their own caretakers during childhood; such similarities, along with a few other

characteristics, determine whether or not the couple is a good Imago match. Instead of soliciting

this information directly, the therapist discovers relevant historical elements as they emerge

during the couple's participation in the Imago Dialogue the three-step structured process that is

woven throughout all stages of Imago Therapy.

Let's look at what the therapist learns about Rick and Denise over the course of coaching

them through sessions of the Imago Dialogue. Rick grew up with an alcoholic father who bullied

him even more than he bullied Rick's mother, a small, frail woman of Mexican descent who

rarely fought back, even when Rick's father went after little Rick, as well. Consequently, as Rick

openly admits, he "hates men." He was in individual therapy for several years for relief of what

he calls his "normally lousy mood," which he attributes to the abuse he witnessed during

childhood. This abuse came from all directions--his father abused his mother, and his beaten

down mother failed to protect him from the rage her oldest child, Ken, took out on the younger

Rick. Rick blames, especially, his father, whom he loathes to this day, referring to him as "the
man who married my mother." Rick admits to having not a single male friend and feeling far

more comfortable in the company of females.

Rick's openness about the vicissitudes of his life contrasts sharply with Denise, who

seems to experience a great deal of anxiety whenever family-of-origin issues emerge during

dialogue sessions. Indeed, during exercises designed to bring childhood wounds to the fore (for

example, the Parent-Child Dialogue), she reveals little about the details of her life as a child. We

do learn that she was the only child of a single Caucasian mother who worked her way through

college, and then law school, starting from the time Denise was an infant. Denise attributes her

professional accomplishments to her mother's positive role modeling: "I figured if she could do

it, I could, too," she states.

But clearly all was not well in Denise's upbringing, although Denise has never been able

to put her finger on it. She remembers little of what happened to her growing up, except for that

fact that her mother was absent most of the time for most of her childhood. She reports being

raised by a string of nannies and babysitters whom her mother--burdened by her studies and part

time jobs followed by her journey up the ladder of a corporate law firm--hired.

Assessment and Case Conceptualization: In order to grasp the dynamics of a couple—to

understand how members of a couple experience each other—the Imago therapists listens to and

observes what the partners are saying as well as how they are saying it. What might an Imago

therapist learn from the exchanges between Rick and Denise? The therapist would discover,

first of all, that Rick and Denise are a classic Imago match. This implies that the very qualities

that first drew Rick and Denise together are the ones that are now generating their greatest

frustrations with each other.

 As far as Rick is concerned, these qualities include Denise’s fierce determination,

independence, and self sufficiency. Unlike the women he’d dated earlier, Denise never expected

Rick to conform to the traditional masculine stereotype that he so despised and rejected, due to

his experiences with his abusive father. Among all the men Denise had met, Rick was the rare

guy who wasn't threatened by Denise's brains and success. This, for Denise, was especially

remarkable, considering they both worked in a high-tech, high-paying nanotechnology positions,

a field containing predominantly nerdy males. in the male-dominated field in which they both

worked. He didn’t ask her to be any different than she was; he seemed to accept her just the way

she was.

But Rick now insists that he doesn’t want Denise to be anyone she’s not; all he wants is

for Denise to “be a wife, someone who wants me, needs me, is turned on by me.” During one of

their dialogue, as Denise listens to Rick’s frustration over the lack of hugging and kissing and

sex in their relationship, she looks stricken. When it is her turn to respond, she has little in the

way of assurance to give Rick. “I’m sorry,” she responds. “I can’t help it. And I’m not entirely

sure this is something I can change.”

Just as children are attracted to playmates who are around the same chronological age,

Rick and Denise were drawn together by their unconscious recognition that, as different as they

appeared to be, they actually had a lot in common when it comes to their deepest feelings.

Indeed, as the therapist listens to their halting attempts to share with each other the pain they’ve

been in, the language this couple uses, the coping strategies they use, their predominant negative

emotions, and the relational themes that keep emerging over and over again, these partners

appear to have been wounded during the second stage of childhood development, the

Exploration stage. In fact, although they seem quite mature and accomplished in other realms of
life, when it comes to their relationship, they sometimes find themselves interacting like a couple

of two-year olds.

What might have happened to these two during those crucial toddler years? How does

this manifest in their relationship now? When the couple agreed to do the Parent-Child

Dialogue, Denise was the first to take on the role of the Speaker (Sender), During this dialogue,

Denise recalled long, lonely periods wishing she had two parents, like the other kids she knew.

She wished she had even one parent. She remembers, in fact, little about her mother and about

how she felt growing up with her.

The exploratory-wounded child grows up to become, in terms of defensive style, either a

minimizing isolator or a maximizing fuser, which pretty well describes this couple. Rick is the

fuser in this pair: he finds himself constantly hungry for and seeking out contact and affection

from Denise, who is turn pulls away or shuts down to stave off his neediness. She admits having

great difficulty giving Rick the very things he wants the most--a classic feature of an Imago

match. She has felt so badly (and hopeless) about her inability that she gave Rick her tacit

approval if he wanted to seek out the emotional (but not sexual) support of other females. In

fact, over the years Rick has formed (with Denise’s tacit permission) a series of online

relationships with women who become for him the confidante he wishes his wife would be.

Rick acknowledges, and Denise agrees, that this has helped compensate for Denise’s struggles to

provide him the physical and sexual intimacy he longs for. Of course, this mechanism has also

enabled the couple to maintain the distance that has kept them both feeling more or less safe, but

decidedly disconnected, with each other.

Treatment Goals: To create the proper atmosphere for Imago work, the therapist’s first

priority is to generate a high-enough level of safety between the partners to enable them to start
picking away at the deep pile of fears, resentments, and frustrated hopes that they both have been

tip-toeing around for years, pretending that there’s really nothing important in that pile.

Specifically, the Imago therapist would help Rick and Denise co-create an interpersonal

atmosphere, or in-between, in which they can both unearth the things they’ve been most invested

in hiding from each other up until now.

Like many “early wounded” couples (those wounded during either of the first two stages

of childhood development, Attachment or Exploration), Rick and Denise trigger in each other the

kind of terror felt by a very young child who has suddenly, to his horror, become separated from

his parents and doesn't know where they are. For Rick, this terror emerges when Denise

responds to his seeking out her love and affection by pulling away from him. Denise reacts with

a similar feeling at those times when Rick, out of his deep discouragement, mentions the

possibility of ending their relationship.

A second treatment goal involves integrating small behavior changes into the couple’s

repertoire. The couple learns the Behavior Change Request (BCR), which turns a complaint into

a very simple, specific request that is possible to do with a small amount of effort. By granting

such a request, the giver experiences an increment of growth while the receiver heals due to the

gift of the giver.

A third goal of treatment would be to help both partners take responsibility for

uncovering and expressing whatever thoughts and feelings they had been denying or dismissing

up till now. For Rick, this would involve suggesting to Denise a few gestures of affection she

could comfortably grant him on a regular basis for a short time period. For Denise, who learned

to deny any need for dependence, affection, and emotional sustenance from her caretaker, this

means moving slowly and incredmentally toward Rick rather than away from him.
 Treatment Process: Early Phase

Establishing the therapist’s role: In comparison with therapists using traditional couples

therapy approaches, the Imago practitioner takes on a unique role vis a vis the couple with whom

they are working. From the first moment of the first session, an Imago therapist serves as a

teacher, facilitator, coach, and model. She does so in a variety of ways; for example, by teaching

and modeling the presence that is part and parcel of the Imago Dialogue; by staying allied with

the couple’s relationship rather than with either individual; by holding (believing in) and

expressing to the couple what she views as the greater potential for their relationship; and by

viewing their relationship as having a higher purpose, that is, to become a microcosmic

expression of a universe engaging in self-repair.

Helping the couple establish safety in their relationship: Typically, during early sessions

Imago therapists help orient couples toward a new way of thinking about their relationship by

providing didactic information, or psycho-education. This information is likely to include, for

example, how the human brain is primed to equate feelings of emotional threat with threats to

one’s physical survival; how defenses arise unconsciously and automatically as the brain’s knee-

jerk reaction to threats; and the importance of intentional behavior to creating safety—that is, we

become aware of our own internal reactivity as well as becoming sensitive to that of our partner,

because safety us requires to avoid, whenever possible, re-triggering our partner’s childhood

wounds.

The Commitment Process: A second initial commitment we ask all couples to make is to

re-commit to their relationship. There are two prongs to this commitment:

1) We’d ask Rick and Denise to make an initial commitment to attend twelve sessions of Imago

Relationship Therapy, which we refer to as commitment to the relationship; and 2) We’d ask
them to fully commit their time, energy, and resources to the process of transforming their

unconscious relationship into a conscious one. We’d remind them that no one can swim very

well if he keeps half of his body dry and out of the water; if you want to swim properly, you have

to allow your entire body to get wet. Similarly, you need a full-fledged commitment to do the

difficult work of transforming your relationship.

Closing the Exits: Closing the exits involves helping each partner identify how they

deplete and divert the energy required for a healthy relationship by investing, instead, in other

people, activities, or things. This process involves having partners make their own list of exits

and then asking them to share them using the Imago Dialogue, which we’ll describe in just a

moment. The ultimate goal of this exercise is to help the partners voluntarily and intentionally

close whatever exits they are using to avoid the pain (and the potential pleasures) of working on

their relationship.

Treatment Process and Strategies: Middle Phase

Teaching the Dialogue

Step One: Mirroring: Mirroring is the skill of reflecting back the message that the other

person is sending. Accurate (or flat) mirroring involves paraphrasing what the other person has

said without adding to, subtracting from, or otherwise distorting what the partner said. Flat

mirroring means not only mirroring back messages that might, to the receiver, seem unimportant,

illogical, or otherwise at odds with the listener's perspective. It means accurately mirroring back

not only the content of the sender's message but also its emotional tone and intensity.

Let’s listen in as Rick and Denise practice mirroring.

Rick: I feel totally rejected when you tell me you’re not interested in having sex with me.
 Denise: I’m hearing you say that my not wanting to have sex with you makes you feel

rejected. Did I get that right?

Rick: Yes, that’s correct.

Step Two: Validation In the validation step, the Listener summarizes the message he’s

heard from the sender and then articulates her understanding of the partner's point of view. In

validating, the Listener makes an explicit statement like, "I understand why you see things the

way you do. You make sense to me."

We need to point out here that validation is not agreement. Helping Rick make logical

sense out of what Denise is saying is not the same thing as gaining her agreement. But validation

goes a long way toward easing the tension inherent in conflict, even if the couple continues to

disagree about the substance of the matter. However, validation is also a demanding task,

especially for couples with early wounding and a lot of anxiety, like the present couple. There

are several ways to help couples tolerate the demands of validation; the therapist would suggest,

for example, that they adopt an attitude of openness and curiosity, rather than judgment, as they

listen to each other; that they make sure they have accurately understood the other’s message

before attempting to validate it; and summarize the Sender's message completely and accurately

before trying to validate it; and to surrender the need to make the other person wrong.

Here’s an example of validation in a dialogue between Rick and Denise:

Rick: When you don’t want to make love with me, it makes me feel ignored and

rejected, just the way I felt when my father was cruel to me and my mother ignored how much

pain he was causing me.

 Denise (summarizes, then validates): I can really understand how you would feel ignored

and rejected by me when I don’t want to make love. It makes perfect sense that you’d feel the

same way you felt when your father abused you and your mother didn’t protect you.

Step Three: The final step of the Dialogue, Empathy, asks partners to "feel with" the

Sender by imagining the emotions the other partner is experiencing. To express accurate

empathy, the Listener needs to listen closely to what the Sender is saying in order to discern the

emotions between the lines. Here’s an example of Rick expressing empathy toward Denise:

Denise: I feel so inferior when you bring up sex, like I’m hopelessly abnormal and

undeserving of your love.

Rick: I’m hearing that you feel really terrible about yourself when I bring up our sex life;

you feel undeserving of my love for you.

Session-by-Session Highlights

Sessions One and Two: During these sessions, Rick and Denise agreed to the Twelve

Session Commitment and to postpone making any decision about staying in or leaving their

relationship. They learned and practiced the mirroring step of the Imago Dialogue; they also

completed the exercise called Closing the Exit; Denise agreed to close all of her exits, while Rick

couldn’t yet promise (at that point) to refrain from chatting with his female friends online.

Sessions Three through Five: The couple learned and practiced the full three-step Imago

Dialogue. By the fifth session, they had mastered the process and were practicing the Dialogue

regularly at home, between sessions. They also learned and practiced the Parent-Child Dialogue,

which helped them connect the dots between their childhood wounds and how they felt and

behaved toward each other in their current relationship.

 Sessions Six through Eight: During this period, the therapist helped the couple focus on

deepening the Dialogue. In doing so, they began to discuss the deeper, more painful feelings that

had gotten them stuck in the power struggle.

Sessions Nine and following: Rick and Denise, having slowly relaxed enough to talk

about what was happening between them, were ready to work on changing their behavior in

ways that would show love toward the other. The sexual arena continued to be almost too

charged to address, but slowly, over the course of several months, they began to have more

frequent intimate exchanges where they would spend some time touching, cuddling, holding, and

so forth. They finally did make love twice during the same month, and in a major breakthrough,

Denise initiated having sex, to the delight of Rick who, the following day, so decided to close all

his exits that involved female friends.

Outcome of Therapy with this Couple

After finishing the first series of twelve sessions, Rick and Denise wanted to continue

coming, which they did for close to a year. Other aspects of Imago Therapy were more difficult

for this couple. They found it hard, especially at first, to follow through with the behavior

change requests they’d agreed to; for example, although Denise agreed to participate in intimate

(but not sexual) touching with Rick once a week, on Saturday mornings, she would occasionally

schedule other activities during that time period, thus making herself unavailable for Rick.

When this lack of follow-through occurs (as it often does with initial behavior change requests),

couples are advised to modify their agreement, making it more do-able and easier to accomplish.

They are helped to understand the value of dialoging about how the anxiety raised by the request

had its roots in childhood. This is precisely what Rick and Denise did, as far as scheduling their
intimacy sessions. Happily, they began to make slower but more definite progress toward

incorporating physical intimacy into their relationship

Rick had his own struggles with following through on Denise’s requests of him. - His

major strategy for dealing with his lack of intimacy with Denise, you may recall, was to seek it

out from women he’d met on the internet. Although he initially agreed to close this exit, it took

him several months, well past the twelfth therapy session, to terminate his interactions with his

longest-standing female friend. Once he finally did so, he realized that he had what he called an

“addiction to romance,” recognizing it as a poor substitute for working on creating intimacy with

his wife, as difficult as that might be.

Therapeutic Obstacles: Imago Therapy follows the premise that virtually any couple

who is sufficiently motivated and well-intentioned can benefit from the Imago Therapy

framework. As always, the devil is in the details; for Rick and Denise, this meant frequently

reminding them of their strengths, reassuring them of their ability to make changes in their

relationship, and encouraging them to take time-outs whenever they became overwhelmed

during a Dialogue.

Implications for Training and Supervision: Tips for Trainees

Remember, less is more: One tendency shared by newly trained Imago therapists is to

overload couples with too much didactic information all at once. Although education is a vital

part of the Imago process, we’d recommend that the trainee, instead of focusing on verbal

explanations of Imago concepts, emphasize providing the couple with opportunities to

experience these ideas for themselves, through carefully structuring and coaching them through

the Dialogue and other Imago processes.

 Go as slowly as you must: Similarly, the Imago trainee must be careful to adapt the pace

and flow of therapy to match the features of a given couple. As any experienced therapist

knows, couples vary a great deal as far as their psychological sophistication, emotional maturity,

and baseline level of skills.

Keep your eyes on the in-between: In Imago, the important “action” takes place between

the partners; what occurs between the partners and their therapist is secondary. Maintaining this

focus might mean that, for example, when a partners turns to the therapist to make a statement,

the therapist, in turn, asks the partner to speak to the other partner, instead.
 Application of Imago Relationship Therapy to the Case of Ben and Alyssa

APPLICATION OF IMAGO RELATIONSHIP THERAPY ON A “COUPLE AT RISK”

This section describes how the first several sessions of Imago Therapy might proceed,

showing the application of specific strategies that might be used with Ben and Alyssa, the case of

the couple-at-risk.

General Overview of the Therapy Session

Throughout the course of therapy, the therapeutic process includes the application,

relevant to the specific needs of the couple, of the ten therapeutic tenets of Imago Relationship

Therapy discussed earlier. Because working within the time constraints of a 45-50 minute

session often cuts short affective processing, Imago therapists typically work in one and a half

hour sessions. With the couple’s permission, the therapist will audiotape the session and then

give the audiotape to the couple to review between sessions. The therapist provides other in-

between session assignments to help the couple practice what they have learned, maintain their

connection, and achieve an environment of safety at home.

A Couple at Risk - Session One

Often, premarital couples who are on second or later marriages go to an Imago therapist

to ensure that they don’t make the same mistakes they made in their earlier marriage. Remarried

or early-married couples with relatively minor levels of conflict might seek therapy because they

heard, by word of mouth, that Imago therapy is skills-based, offering tools that help make good

marriages better. Couples whose conflicts are intense (hot marriage) or who have given up

(parallel marriage) tend to go to therapy to find a mediator or referee with the option of divorce.

With all couples, in the first session the Imago therapist would ask Ben and Alyssa to take turns

“sending” and “mirroring” why they think the other chose to enter therapy and what their partner
wants to achieve. S/He might then ask them to tell each other how “I have prevented the

marriage we both want from happening.” The purpose of this structured process is to prevent

them from engaging in a recitation of their frustrations with each other, thus creating a safe

therapeutic environment.

Next the therapist would attempt to elicit the “core scene” by asking Ben to tell Alyssa

what he thinks is her deepest frustration with him and ask Alyssa to mirror it. It might look

something like this: “Alyssa, from my perspective, your deepest frustration with me is....” When

Alyssa finished mirroring, the therapist would prompt her to validate his perception by

suggesting the sentence stem, “you make sense, because....” and then offer her the opportunity to

learn empathy by prompting her with the phrase “and I can imagine that makes you feel....”

(Note: the movement to validation and empathy requires a clinical judgment that the couple can

do it. If by experimentation or intuition, the therapist decides they are not ready, s/he asks them

to limit their response to mirroring, and introduces the other processes later in therapy.) The

therapist would then ask her to respond by confirmation. If he was wrong, the therapist would

ask her to correct him by reporting her deepest frustration and ask Ben to mirror, validate and

express empathy. Then Alyssa would switch to the Sender role and communicate her views of

Ben’s deepest frustration with her, and the therapist would facilitate the same process until the

core scene was described. In the process, the therapist might offer a sentence stem like: “and

that reminds me of...” seeking to evoke conscious connections between current frustrations and

childhood experiences.

As they dialogue about their marriage and their childhoods, the Imago therapist would

listen for clues to their developmental wound and observe their defenses. S/He would note, in

this instance, that Ben and Alyssa appear to be wounded in the transition stage from exploration
to identity. Ben appears to have been smothered by his single mother and defended himself by

minimizing his responses. Not having a father, he seems to have over identified with his

maternal uncle who encouraged him to be a lawyer and internalized his reserve, thus reinforcing

his minimization and tendencies toward being controlling. Alyssa appears to have been wounded

by her mother’s neglect and her father’s controlling manner and to have identified with her

mothers affableness and father’s sterness and, later, his religion. Although she appears

compliant, she tends towards maximizing her affective responses through exaggeration. Because

they were not suffering from early wounding, and because of their education and sophistication,

the therapist may decide that they could easily engage in the full dialogue process.

The therapist might close the session with some psycho-educational input about the

importance of commitment to both the relationship and to the process of therapy. S/He would

suggest a twelve-session commitment, to be revised later if necessary, and ask them to indicate

whether that made sense to them. For the purpose of this chapter, it will be assumed that Ben

and Alyssa have committed to four sessions and have not heard of Imago Relationship Therapy.

Before they left, s/he would give them a “between” session assignment to practice the dialogue

process in their daily interactions and limit discussions of their relationship to small issues.

By the end of the first session, the Imago therapist has already: 1) taught the Couples

Dialogue; 2) begun fostering differentiation by putting one in the shoes of the other; 3) increased

the awareness of the frustrations of each partner; 4) decreased criticism and defensiveness by

having the partners identify the other partner’s frustrations, rather than allowing partners to tell

one another how frustrating the other person is; 5) allowed the couple to experience the

projective process and the distortions they may have had regarding the other’s frustrations; 6) got

an initial commitment to the therapy process; and 7) with the “between session” assignment, got
them started on integrating dialogue into their lives. Simultaneously, the Imago therapist took an

informal case history of the couple, noting important issues like family of origin and their

nurturing deficits from childhood and their character defenses. S/He also has some information

about their career choices and their sexual relationship.

Session Two

At the beginning of session two, the Imago therapist would continue integrating the

dialogue process into Ben and Alyssa’s relationship by asking them to alternate sending and

mirroring about their experience of the first session and the between session assignment to use

dialogue. S/He would be especially interested in their response to the dialogue process and might

inquire whether or not they might integrate it into their relationship outside of therapy.

Then the therapist might give some psychoeducational input about the human tendency to

use defenses whenever one is emotionally threatened, underscoring the importance of

establishing emotional safety whenever emotionally-laden issues are discussed. S/He might

explore with Ben and Alyssa how they have been dealing with conflictual issues, for example,

whether one “flees” from conflict while the other “fights ” in order to confirm his/her impression

of who minimizes and who maximizes.

The therapist may then turn to deepening their understanding of the quantity and depth of

the frustrations by continuing the process begun in the first session that elicited their core scene.

Using an exercise referred to as the “Frustration List,” with “frustration” referring generically to

behaviors that produce negative emotions, the therapist helps them discover the pattern in their

frustrations, I. E., how they lay the foundation for and build up to the core scene. The process

consists of asking the partners to write down, in session, a list of the things each of them does

that they perceive frustrates their partner. Sometimes the Imago therapist might ask the partners
to rate each item on the list on a 1-10 scale, to indicate the extent to which the frustrating

behavior disrupts the couple’s relationship. When the lists are finished, the therapist would then

ask the partners to share each item on their list with one another: “Ben, I would like you to tell

Alyssa what you believe makes her become frustrated with you.” Ben would then read an item

from his list: “You get frustrated with me for not being religious.” Depending upon his/her

assessment of their ability to do the complete dialogue process in the first session and the success

of their work between sessions, the Imago therapist would facilitate Alyssa’s response to Ben’s

message. If the therapist sensed that she could validate his message, s/he would encourage her to

do, explaining that she did not have to agree with his assessment of her frustration. She only had

to “see” his point of view. Once Alyssa completed her response to Ben’s item, the therapist

would ask Alyssa to share with Ben an item on her list. “You’re frustrated,” Alyssa might state,

“that I don’t spend as much time on you as I did before Benny was born.” Ben would then

respond with dialogue to Alyssa’s statement. After each frustration has been shared and

mirrored, the therapist would elaborate on the three phases of the dialogue process (mirroring,

validation and empathy) and coach them in dialoguing about a “moderate level” frustration on

one or both of their frustration lists.

In Imago Therapy, frustrations are considered the “royal road to the unconscious” which

provides a glimpse into unresolved issues from childhood. Thus, frustrations are often used as

the benchmark for gauging “childhood wounds” and developmental lags. To demonstrate, later

on in the therapeutic process, the partners receive an opportunity to add to the frustration list that

was generated by the other partner; that is, each partner is allowed to share what the other partner

did not accurately identify as frustrating. Suppose Alyssa lets Ben know that she gets frustrated

when he doesn’t listen to her talk about the nightmares she’s been having. From this, the
therapist might surmise that “not being heard” may be a painful issue for Alyssa, one possibly

left over from the identity stage of development (around three to five years of age, according to

Imago theory). If Ben, on the other hand, expresses the frustration that he is being overly

controlled (“Women have choices, men don’t,” as he stated), the therapist observes that Ben, too,

might have issues stemming from the identity stage with residues from the stage of exploration.

Regardless of the content of the dialogue, afterwards, the therapist asks each partner to

report how they experienced the exchange, explaining that, although the process might feel

“mechanical” or “unnatural,” it is nonetheless essential to developing a healthy relationship and

that it will not only feel natural, but desirable as they master the process.

At session’s end, the therapist might give one or more between-session assignments. A

typical assignment would be to spend 10 minutes a day dialoguing about “small” or “moderate”-

level frustrations from each partner’s frustration list, alternating the roles of Sender and

Receiver. The therapist might also give them an article on Imago RelationshipTherapy to be

read aloud together.

Session Three

At the beginning of the third session, the Imago therapist would begin by asking Ben and

Alyssa to share the intentional behaviors they engaged in for one another since the last session

and to acknowledge what they saw their partner do for them. This exchange encourages a focus

on the positive aspects of the relationship. Next, the therapist would check on whether and how

successfully the couple completed the between-session assignment.

The third session might include another psycho-educational component, namely, the

theoretical notion of the “Imago” and its role in the partner selection process and the concept that
marriage, in Imago, is viewed as nature’s way of bringing together two people for the purpose of

healing and characterological growth through mutual stretching.

Having earlier noted the couple’s facility with the Dialogue process, the therapist would

have them dialogue during this session about a small frustration, this time stating their frustration

rather than their perception of their partner’s, in order to teach them the Behavior Change

Request process. Alyssa’s frustration, for example, might be that Ben does not take the time to

listen to her anxieties about the upcoming birth of their second child. After the two dialogue for

awhile about this, the therapist would direct Alyssa to generate three specific, measurable and

time limited requests for behavior changes from Ben, changes that would ease the frustration

Alyssa expressed during the dialogue. In light of her frustration, one of the requests might be,

“In the next two weeks, if I have a nightmare, I would like you to hold me and mirror, validate

and empathize the details of my nightmare back, either immediately after the dream or before

leaving for work the next morning.” After she has stated two other requests and Ben has

mirrored them, the therapists informs her that s/he will suggest to Ben to select the easiest of the

three so that he can succeed in making a small change. Once Ben commits to fulfilling one of

Alyssa’s requests “as a gift,” the therapist has Alyssa initiate some “high-energy fun” with Ben,

intentionally engaging him in an enjoyable behavior, such as a 30-second hug, thus promoting a

sense of well being and facilitating connection.

Toward the end of this session, the therapist moves Ben and Alyssa into a guided

visualization of their “dream relationship” as it would look three to five years in the future. After

this, the therapist gives each partner each a worksheet titled “Your Relationship Vision.” The

between-sessions assignment for the week is to individually write down positive statements to

describe their relationship vision using the pronoun “we” and write each statement in the present
tense, as though that segment of the vision was already fulfilled. Next, they are to spend time

sharing their vision list, mirroring back to one another each sentence, and noting the items about

which they mutually agree. These items are then transferred to the “Our Relationship Vision”

form, which they complete and bring in to the next therapy session.

With couples who are deeply engaged in the power struggle, unlike Ben and Alyssa, the

Relationship Vision process would not be effective this early in therapy; however, the Vision

List should be completed as soon as possible after therapy commences in order to chart the

direction of therapy.

Session Four

In the fourth session, the therapist would begin by acknowledging that this was the last

session to which they initially committed. The therapist asks how they have experienced the

process and the effects of therapy, especially the dialogue process. S/He may also inquire

whether or not they wish to continue or terminate with this session.

Whether or not they choose to continue, the therapist asks Ben and Alyssa to share their

mutual relationship vision list and teaches them how to change the general vision statements into

behavioral goals using a Model Goal Sheet. For example, “We have fun regularly,” can be

changed into an objective that will help to attain the goal, “We will have high energy fun once a

week.” Each objective is placed within a time frame, such as “3 weeks.” Then the therapist

assists them in developing a strategy to achieve the goal. For instance, the tactic that results in

fun is to “See a funny movie once a week and play a silly game each Sunday.” S/He then asks

them to describe the likely sensory effects of achieving the goal, such as: “We will feel light-

hearted and relaxed,” all of which is written down. The Goal Sheet also allows the couple to

record their progress toward the goal as well as to revise their plan if they desire. The therapist
may also suggest that Ben and Alyssa place their Relationship Vision somewhere in their home

where they can read it together regularly, review it, and change it if appropriate.

To close the session or the therapeutic process, if they have chosen to do so, the Imago

therapist discusses the different types of extis and the No-Exit Decision. Because Ben and

Alyssa both believe that they do not engage in any catastrophic or terminal exits, they dialogue

about the intentional or functional exits either of them use. For example, Alyssa might express

to Ben, “I think I use spending time with Benny as a functional exit.” By this, Alyssa means that

spending time with their child is necessary and enjoyable, but that there are times when her over-

involvement with Benny results in an under-involvement, a depletion of time and energy, with

Ben. Ben and Alyssa then dialogue about the effects of Alyssa’s exit on Ben. This dialogue

might be followed by a behavior change request from Ben to Alyssa, which might include, “On

the next two Saturdays, I’d like you to leave Benny with a babysitter for three hours so that we

can have an intimate picnic in the park.”

At the end of the session, if the couple contracted to continue therapy, the therapist

would give an overview of what additional sessions would cover and describe the benefits of

introducing passion, the re-romanticizing process, into their relationship.

General Comments
 28

Ben and Alyssa came into therapy with an already-firm commitment to their

relationship, which was not yet fiercely conflictual (they wanted to “make a good

relationship better”). They also were already exhibiting signs of empathy and intentional

behaviors. Thus, they found it relatively easy to engage in the Couples Dialogue and

were readily receptive to the idea of gifting one another through the Behavior Change

Request Process. In addition, both Ben and Alyssa expressed that they had been feeling

unheard and misunderstood. The dialogue process therefore would likely have an

immediate and positive effect on their relationship. If, however, the couple found

themselves having difficulty listening to one another, following through on commitments

to behavior change requests, or remaining dialogical with one another between sessions,

the Imago therapist would engage then in some regressive work. This would enable the

couple to understand the deeper emotional roots of their relationship problems. For

instance, if Alyssa found it difficult to empathize with Ben’s unhappiness with his job,

Ben could be led to recall his childhood and adolescence, during which he felt pressured

by his uncle’s role modeling, his mom’s high expectations of him, and his overall sense

of feeling controlled by others. Once such connections to childhood wounding are

experienced and expressed, typically an affective shift toward empathic attunement

occurs between partners. In this case, because of her enhanced empathic understanding

of Ben, Alyssa might feel more motivated to grant Ben behavior change requests that

would ease the frustrations he’d expressed, frustrations that were rooted in his childhood

experiences and re-enacted in his marriage.