A Podcast Series from The Family Institute
In this podcast episode, Neil Venketramen, staff therapist at The Family Institute, interviews Dr. Linda Rubinowitz, our senior therapist and assistant clinical professor of Psychology who has been on the teaching and clinical supervision faculty at Northwestern University, and specifically The Family Institute, for 27 years. Dr. Rubinowitz explains how one's family of origin and early experiences affect their current relationship challenges, and emphasizes the importance of respect and care when addressing clients' historical problems in couples therapy.
Neil Venketramen: Hi, everyone. My name is Neil Venketramen and I'm a staff therapist in the couples and marriage family therapy program here at The Family Institute at Northwestern University. I am part of a team of psychotherapists specializing in helping couples and families at different stages in their relationships create pathways to greater understanding and connection.
NV: As a couples therapist, I’m experienced and specialized in helping and specifically addressing issues like emotional distance, disconnection, conflict, financial stress, work-life balance, and so much more with couples. I've created this podcast series to help you navigate through some of the challenges as a couple that you may face on your journey.
NV: Today on the podcast, I have the privilege of hosting Dr. Linda Rubinowitz. Dr. Rubinowitz has decades of experience as a clinical psychologist. For 27 years, and currently, she's been on the teaching and clinical supervision faculty at Northwestern University, and specifically The Family Institute.
NV: The reason I'm excited for today's call is that Linda has been my own clinical supervisor when I was a student going through the graduate program in marriage and family therapy at Northwestern University. Linda's empathy and compassion combined with her clinical experience, makes her the best person to talk about how early family experiences affect our current relationships.
NV: So Linda, thank you so much for being on the call this morning. It’s a real privilege and honor to have you here and I'm looking forward and excited to it.
Linda Rubinowitz: Oh, I appreciate the opportunity. I was looking forward to our conversation.
NV: The topic we're talking about today is family of origin and how one's early experiences actually affect current relationship challenges and how they present in current relationships. So Linda has taught me a lot about this and I can't think of someone more experienced, loving and caring in this field that's going to help us navigate and talk through and share some ideas this afternoon. So thanks again, Linda.
LR: Well, thank you Neil for such a gracious statement.
NV: So Linda, if we're getting into it, the first question I have for you this afternoon is can internalized relationships, and what I mean by internalized relationships is our early life experiences we develop with our families that become part of our personality, can that interfere with a couple's ability to solve problems in their relationships?
LR: Good question and let me sort of provide a context for my answer. And it is, yes. We are born with a neurological and biological system that's unique to us and along with that we have a particular temperament. And then as babies, through interactions with our mothers, fathers, care providers, hopefully we develop a feeling of being loved and emotionally safe as well as physically attended to. If this is accomplished well enough over the early years, we develop a secure emotional connection and become trusting, warm, caring, loving, compassionate, confident, have good self-esteem, and feel comfortable with intimacy.
LR: On the other side, if the infant or child does not feel love and emotionally safe, an insecure connection develops and there are two main types of these insecure connections – anxious and avoidant. The anxiously, emotionally attached person, craves intimacy and tries to foster this engagement, even in the light of inconsistent responses or rejection. And the person who is avoidant fears intimacy and avoids the emotional connection because of underlying feelings that he or she will not get dependable love and therefore that person withdraws to avoid loss and pain.
LR: After those early years, if there is a secure attachment, there still can be things that can go off track in that if the parents or the siblings are particularly critical and the person feels not good enough about themselves because of those messages that they get. They may also feel invisible or abandoned, then these become core issues and can be brought into current relationships because they are so much a part of the person.
NV: This psychological idea that we feel invisible or abandoned, that really affects us and the way we present in our current relationships.
LR: Absolutely. An example is when a couple is having a conflict and they come in and talk about it, and say the husband has some things he wants to do, and if the wife isn't hearing that, and that husband has grown up in a family where he felt unattended to, that will get activated to a stronger degree than if he had come from a family where he felt pretty much attended to, but this time she missed the boat.
NV: All these underlying forces that really affect our ability to solve problems. Linda, how much weight do our past internalized behaviors thinking in relationship experiences where the people we love, our primary attachment figures, actually contribute to relationship conflicts?
LR: Well, they can contribute a lot, but they can also be modified and that's the hopeful part. If the early parenting, say the mother or the care taker wasn't attuned to the baby's needs, when the baby was hungry, they didn't feed the baby or didn't hold the baby when the baby needed to be held, or didn't cuddle and be present when the infant needed them to be present, you can miss a little of that and still do fine. And even if you've done enough and it’s fine, things in life can intervene. You can lose a parent, things can go off track, but you can heal from this, especially if you can find a more stable person to relate to, that will help modify some of these negative voices you have inside yourself. So while you can add a lot of weight to it, you can also modify it.
NV: That's very helpful. It somehow also depends on the quality of relationship that you have with someone is kind of the modifying ability.
NV: So Linda, what are some of the types of examples of family of origin problems with attachment figures that show up in your office? Do you mind sharing a few examples about some of the clients that you've seen over the years?
LR: One example that comes to my mind right away is a young couple. They had been married for two years when they had their first child, and they had had a fine marriage before; comfortable, they agreed to have the child, things were working well, they both were employed, they could see their life together progressing as their goals were set. And when they had the child, the husband had an affair and it was totally shocking to the wife.
LR: And as we explored this in session, it turned out that going back into this family and trying to find his history and bringing his history as well as hers into the room, we found that he had lost his mother when he was ten to cancer and the threat of seeing her focus on the infant so much, which is a normal understandable transition, threw him off his course. He felt abandoned and felt the loss and was looking to be reassured through the love from someone else. And as we were able to slowly and patiently bring that to the forefront, he could realize what he was doing. And she had some empathy for his loss and he could be more present to her to be a better companion in parenting the infant.
NV: That's a really powerful example, Linda. Thank you for sharing that. Is there any other patterns or examples that you-
LR: Another pattern we see is people who have been married for 20 years, the kids are going off to college or to work, and then there's more conflict. The parents aren't happy with each other, the status quo has been changed, there's a major transition. What sometimes comes out is that the husband and wife have been such a good parenting team, that satisfied their need for intimacy and connection which they got through the children. When the children were being launched, they were feeling bereft. And they didn't know what to do with each other anymore. How to reestablish what maybe they had in the very early years of their relationship. If they've had abandonment issues before, they will get kicked up very strongly at this point. It’s an opportunity for feeling and to address it, and it’s also very painful.
NV: What's fascinating listening to you and your experiences in both of these examples; number one, this idea concept of abandonment that you spoke about early in our conversation and how strong of an influence that is. What's also interesting to me is that these challenges with family of origin or going back to our history can happen at multiple points through the life cycle of one relationship. You used the example of the couple that's early on in their relationship when they have a child and the second example when they're transitioning when the kids are leaving home. So these things can show up at different times in the life cycle or-
LR: Oh, if you have an older couple who are in their 80s and there is something that changes through them such as dementia in one of the partners or there's a serious illness, one becomes a care provider, the other feels missing their partner and has to take over so many functions and also doesn't get maybe the same kind of love and attention they had when the partner was well. This can set them into a fear of conflict that they may not have had before. And if in the past, having felt not attended to had been a big part of their life and they had worked it out in their relationship, but now it happened again, the intensity can be stronger and the loss, the frustration, the pain and the hurt that each needs support from each other.
LR: One of the things that I think might be on the hopeful side is that when we talk about these securely attached or emotionally attached people and the avoidantly attached people, that basically, 50% of people have secure attachment, 20% are anxiously attached, and 25% are avoidantly attached, and maybe three to five percent are a combination of anxiously and avoidantly attached. So you can see at least 50% of people have had secure attachment and if that carries through life, they will be present for their partners, which will be healing for their partners, if their partner happens to have one of the other attachment styles, and also satisfying for themselves.
NV: Yes. Now that's very comforting to know as I listen to you say that there is hope. And then transitioning to that, if someone has anxious attachment pattern or an avoidant pattern, what are some of the interventions or your favorite interventions that you've used in your experience?
LR: A person who has an anxious attachment is the one who will keep calling and pursuing and trying to get connection. The one with an avoidant, when hurt, will pull back in order to feel more in control again. So in trying to deal with this, it’s helpful if they will allow, and sometimes it takes patience and time, for us to talk to each of them about their history and how they developed the ways they interact.
LR: And sometimes, if they don't do the history because it feels too uncomfortable, to go back in the history is too painful, you can take an isolated situation that currently is happening and it will probably bring out the issues we want to address; such as this woman who has four children – two of them are off to school, have left home, two of them are still at home. The wife wants to go to a family gathering and the husband wants to go to a playoff football game. This is a direct conflict because she feels he always withdraws and doesn't participate in her family things. And as we understand going back into his history, he felt very ignored as a child, he had a sibling who had serious developmental problems and the parents really focused on the sibling, and he always felt that he was not attended to, his needs weren't listened to. And so in this situation between them, which sounds like, "oh you could sort of mediate this," but it isn't because particularly he felt very unattended to and not seen by her.
LR: But once she could understand why he was so angry, and why he withdrew, that's helped her have some compassion and empathy for him. And when he could see that she really wanted to be close to her family at a time when they were celebrating and he could then say, yeah, he wished he had a family that he had grown up with that he could feel this close to. And so some of the jealousy went down.
NV: I'm hearing the intervention, we call it the clinical intervention when there is really an empathetic understanding of the situation and the skill of developing some empathy and compassion for what's going on. I'm just curious, in some of the work you do, how did you discover some of the ideas?
LR: Through my training to become a clinical psychologist and a family therapist. Plus I relied on my own background, growing up in my own family. My mother was one of eight, my father was one of five and I had 17 first cousins. We all lived within two hours from each other – an hour on each side of the town I lived in and people got together on Sunday. There was lots of fun, lots of conversation, lots of food, lots of conflict. I was the only child in this and so I became like a super observer and tried to figure out how to relate to all these different people because I wanted relationships. And that was sort of early learning for me out of my own personal background.
NV: If you wouldn't mind, I know it’s a really personal question, what was one discovery you made in your own family that kind of shaped your thinking or ideas around this topic?
LR: My parents were in business together, and so we had a person who did the housework and the cooking, and was there for me when I came home from school. She lived with us and was a very, very nice person. She came before I was born and she was there after my parents died. So I had a long history with her and she also had some developmental problems and while I was aware of them, there was a point where I kind of outgrew what her intellect was and I became more of a caregiver for her in a way. It heightened my empathy for someone who is very caring, very loving and has certain challenges.
NV: Wow. So Linda, I want to take maybe a different direction on this and the challenges I see in my own clinical practice in helping clients. Are there situations where it may hurt a relationship or cause more problems when a couple tries to address historical problems in their relationship?
LR: Yes, if they're in a high-risk situation, you need to address the situation first. If there's a serious illness with a child, you try to do what you can to stabilize situations before you bring in more complexity from the past if you can do it in the present because you don't want to add more challenges for them. So in a high-risk situation or something that's very demanding, go slowly.
NV: Yes. Do you mind if we take an example here to flesh it out a little bit? Let’s just say, for example, a common intimacy theme I see is where a husband is nervous and reluctant to express his need for love and connection for fear that his wife might humiliate him. The husband was humiliated by his caregivers when he made a bid for love and connection, you know early on through his development phase. The wife does not know about this in our hypothetical example here. But would it be safe in this situation to look for family of origin constraints, if you want to call it that, to try to unravel this problem when his wife is present in the room?
LR: I think it’s a judgment call. And sometimes in this situation, I'd meet with each of them individually and try to assess if it would be helpful or not and if it looks like they might be open to this, and both of them would have to be open to hearing issues that he would raise, and he would have to feel more prepared to hear what she might say. And then, I would be there to help them through that conversation if they decided to go ahead. But I’d check it out individually first because as you said the feelings of pain, hurt and shame are very hard to deal with. So I would be careful and try to set a safe enough environment in the office first for them to feel trusting of me, and then meet individually to deepen that trust and help if they would decide to go ahead and prepare them do that.
NV: I feel that this is one area that is the most rewarding type of work to do as a therapist. Here is the type of work where you get to work sometimes with an entire family and requires compassion, care, understanding and empathy. We’re privileged to be invited into this very special experience with our clients.
NV: We also have a duty of care to respect this experience. Although the work is very rewarding and significant for any family, especially if you're bringing parents or caregivers into the room to help understand and remove some of the challenges, it also creates a deep level of resistance. The clients are afraid or resistant to talk to their parents, they even find it too anxiety provoking. What recommendation would you give to someone listening who may want to start a conversation with their family, but the conversation itself just brings up resistance?
LR: First thing I would say is to understand that resistance is usually fear. And so if you feel a partner is resistant to talk about it, this requires empathy to understand that there's something that feels so threatening to this person that they can't do it. And if that's the case, then it’s necessary to have more contact that allows for some respect and for the need to go slowly for that person. Sometimes there's a reason not to go forward because it could be too damaging. So, I think, to be able to listen to that person's intensity around the resistance and if they can talk about what they think might happen if they did it without doing it, you'd get the fears underlying and then you might get that history that relates to the fears and then they can lay all that out in front of them and then make a decision if they want to address it.
NV: So I'm hearing you say that if a family or a couple has fears about doing it, there's some work that's required. Slow work, pre-preparation, and doing it in an empathetic way that gives everyone a chance to buy into it. Maybe seeking some help to do this?
LR: Absolutely, and that's where I think a therapist can be very helpful. Both slowing down the process and then respecting each person and their own needs, and bringing information that they can look at together in a safe environment.
NV: Great, I like that idea, Linda, that you don't have to do it alone. Linda, what research or resources would you suggest that a couple get access to to understand more about this topic?
LR: There's a wonderful book and it’s written in a very reader friendly. There are question and answer parts to it that will help you understand what your attachment style is and give you ways for dealing with it. It’s called Attached: The New Science of Adult Attachment and How it can Help You Find and Keep Love by Dr. Levine and Rachel Heller. Then there's another one called What Children Learn from Their Parents’ Marriage by Judith Siegel. And if someone is interested in going back into their parenting part, I have one other book to suggest, and I know there are many of them, but this one seems to be very helpful to people. It’s called Parenting from the Inside Out: How a Deeper Self Understanding Can Help You Raise Children Who Thrive and this is by Daniel Siegel and Mary Hartzell.
NV: Thank you, Linda, that's very helpful and I'm sure I've read some of that and it’s very powerful so thanks so much for sharing that.
NV: Sometimes in our clinical work, I may leave a session or my clients leave a session with an index card, on which I'll write a sentence or two about what they need to do until our next therapy session. If you were to leave our audience here with a metaphorical index card, or maybe put something up on a billboard, what would it say?
LR: Depending on the person and the issue, well one of the index cards would say, "Accept your feelings. Calm down. Allow at least 20 minutes and take responsibility for your part in the conflict, then reengage, but before you reengage think strategically."
NV: Wow, I love that. Accept your feelings.
LR: The second card I'd say, "Listen to the other person and do not think about your response while you're listening because this is how you can really have empathy."
NV: Such good advice.
LR: I’ll give you a couple more. If it’s a couple that does a lot of blaming and attacking I'd say, "Don't blame and don't attack. If you have issues and you can't deal with them during the week, draw a circle around it, bring it here, but don't blame and attack because that will spiral down."
LR: The next one would be, "Empathy, empathy, empathy for yourself and the other. And then do something fun."
NV: I like that. That's really good advice. Linda, it’s been an absolute pleasure, thank you so much for sharing your wisdom. Final question: if someone needs some help in this area, how can they get a hold of you or be in contact with you?
LR: You can call or email me at Linda Rubinowitz at The Family Institute at Northwestern University. The phone number here is (847) 733-4300 and you contact registration at extension 263. Or you can email me directly at firstname.lastname@example.org.
NV: This podcast is brought to you by the Family Institute of Northwestern University, a nationally recognized leader in the field of behavioral health. We bring together the right partners to support children, adults, couples, and families across a lifespan. As researchers, educators, and therapists, we work with our clients and partners to seek change. If you'd like to request an appointment, please call us at (847) 733-4300. You may also visit our website at www.family-institute.org and please follow us on Facebook and Twitter for relationship tips and tools and for updates on the new podcast episodes. Thank you so much for listening.