New Beginnings Therapy

     Vulnerability as the core of Anxiety disorders

 Beck, Greenberg and Emery (1985/2005)

How vulnerability as a concept can be explored in 

couple therapy during psychological transitional stages 

Pragma - Mature love: concept of vulnerability and significance in couple therapy. 

Tavistock Relationships Clinic and Planning Retirement Project

Disclosure statement: The following article is based on Western academic concepts and corresponding understandings on what mature love and couple relationship means: it would not be wise to extend and or generalise such concepts cross-culturally; it would also not be wise to consider the illustrative example outside the UK border because couple client presented was a UK resident at the time of interview, however, that is not to say that couple client is a UK citizen because it was more likely an EU citizen at the time and potentially a global citizen in its status - on such account, couple relationship presented can be interpreted at large and across various world cultures whereas agreed understandings on couple relationship exist. 

I hesitated slightly and only slightly to open up a conversation about the concept of vulnerability and it was only when coupled with understandings gained during my practice at the Tavistock Relationships Clinic, my work in couple therapy, revived realisations of what “pragma” means and revisited couple case's diaries - as a cumulus - it offered me a sense of: yes, perhaps in this context, “pragma” and "vulnerability" can be developed together to a conceptual stance.

Beck et al. reference is about a passage of time linked to a conceptual progression on an understanding as to how "vulnerability" remains at the core of anxiety disorders. Twenty years later after first edition published on relationship between anxiety and vulnerability, such a relationship is still very much discussed from a cognitive theoretical perspective.

In the context of this article, the concept of maturity in a relationship - hence pragma - is paired with  an existing client couple's anxiety (couple's vulnerability) to better understand factors involved in the development of a mature love. The analysis was made possible through clinical observations, explorations and reports in couple therapy sessions some years ago at The Tavistock Relationships, London where approaching retirement was transitional stage targeted for intervention. 

What is pragma? 

Pragma as a mature love has been described by the Greeks as a type of love that is developed between romantic couples where main characteristic of a relationship is that of “giving” to each other. It must be distinguished from various other types of love i.e. self-love, selfless love, love developed between people that have a shared common goal etc. There are few considerations when assessing pragma as love developed over time between couples. One such consideration is a determination as to when a couple’s love can be seen as mature love. Maturity would suggest a relative long period of time and what can then be formulated as a first question is whether or not length of time or period* of time is indeed determining factor in a definition of “pragma”. Is it possible that some other factors besides the length of time, are more essential to assess and attribute to a relationship that is then classified mature love or “pragma”? The suggestion of this article is that such factors do exist and perhaps are primary to an assertion on length of time. Moreover, a strong consideration could be given to two specific aspects of such factors/components of pragma relationships: a) couple’s negotiation of all components of a pragma relationship b) the timing of that negotiation being completed with all aspects present and agreed upon.

One possible argument is that the length of a relationship can only confer a greater opportunity for all elements of pragma relationship to be identified, recognised and incorporated into that specific relationship. Some potential factors are:

1. Trust;

2. Respect;

3. Commitment;

4. Supportive of each other and acting on each other’s best interest at all times including domestic stability and financial security;

5. Resilience: overcoming difficulties and negotiating relationship’s best interests together;

6. Tolerance – agreeing to work together through differences and find resolve to such differences, if any;

7. Romantic love asserted through mutuality and reciprocity bounded by couple’s agreed meanings;

8. An equal contribution and responsibility for maintaining a harmonious, healthy, connected and communicative environment for any dependents that the couple may have, everyone’s wellbeing, healthy development of couple’s relationship and all relationships derived from the couple’s status quo;

Above are only few of the factors that can be identified in a romantic relationship that can be termed as pragma. It is without a doubt that length of couple’s relationship is highly significant, however, when employing the term “mature” love, one needs to be rather cautious in what that then may suggest. First question to ponder on is whether or not a couple that had been in a relationship for a 12 months period of time and have successfully negotiated, agreed and acted on all above factors mentioned, could be termed as mature love or pragma couple relationship.

Second question to explore  is whether or not a couple that have been together for twenty years, no dependents and during a period of transition couple’s relationship becomes vulnerable and challenged by each partner different views on such a transition. Would then, in such circumstances, couple relationship can still be defined as “mature” love and or pragma? What if a different couple with same period of length of relationship and circumstances, faces a similar transition and it is realised that it poses no challenges as the couple already negotiated and successfully agreed on all aspects of such transition?

My proposed questions are offered for reflection and are meant to highlight complexities of a couple relationship and more so consider potential impact on the couple client's resilience when a specific life event or psychological transition takes place. A couple’s relationship with its components form central element on a definition of mature pragma love, and it would be only fair to note that factors 1 to 8 achieved on a continuum would give an ideal form of pragma couple relationship. Such an ideal, in our opinion, not only that is hard to achieve but quite impossible to exist at all times in realities of our lives. Factors 1 to 8 represent the negotiation itself and that can take place in many stages and at differing times. It is asserted by this paper that that negotiation and the success of that negotiation of factors 1 to 8 represent pragma love and yes, it needs, indeed, a relatively long period of time but that is not to say that it needs a minimum of a decade; it is our argument that it can be achieved in a 12 months period, too. Perhaps one other factor to account for is that a couple themselves can determine such a period of time considering at minimum of one life event and or psychological transition that the couple have negotiated and successfully completed together i.e. moving in together. Life events and or transitions should be decided by the couple and examples are limitless as to what can be considered as a life event and or transition within a couple relationship with significant psychological determination.

Pragma and vulnerability – where is the “fit”?

In order to illustrate such a process and the complexities of such analytic encounter, I am going to present work with a couple client and aiming to extend understandings around resilience and  couple’s vulnerability as a response to a psychological transition. Case presented/couple client was assessing a decision about early retirement.

Strand and Ran have been together for 17 years. Strand is in early forties and Ran in late forties. They are both British, sharing a home and had lived in the UK for at least the duration of their relationship. Ran is retired from work and Strand is currently assessed for an early retirement on medical grounds. The couple have no children and that is being felt as a great loss to their relationship and family life. The couple indicated that, to some extent, the couple’s nurturing need was attended to by their involvement in the care of close family members’ young children. In thinking about couple processes and the relationship as being crucial factors for the therapist, I have decided on an orientated approach,  implementing a new model from Tavistock Relationships developed for couple client therapy and decisions on early retirement. Initial session was offered as a deciding session in thinking with the couple about their relationship, allowing for a couple dynamic to develop in the therapeutic room and presenting a "third" as a relationship in the room. Clinical supervision and clinical discussions with other peer clinicians at the Tavistock Relationship Clinic were important aspects in gaining a better understanding of the theoretical framework employed and how to proceed with a relatively novel intervention. Before first session, the couple and I met in the waiting room area and as we all entered consulting room, both partners were still preoccupied with some of the questions on the pre-session form provided by the clinic’s reception. Ran asked Strand what marital status had provided as an answer on clinic’s form. It seemed that in completing the questionnaires, Ran had an immediate response, prompting a reflection on whether or not the couple is presenting as agreeing on a marital status of their relationship. It seemed that relationship status was proposed as a beginning point of discussion for the relationship in the room. I addressed that in asking Ran and Strand, what it meant to feel unclear or uncertain about their relationship status -  such observation then had to address questions around how partner's needs are responded by each individual couple partner. In psychotherapeutic terms we refer to such needs as a “couple fit” a way of describing how two partners in a couple respond and relate to each other.

There is no need to continue illustrating such example beyond this point, because what was revealed, in this case, there was a clear vulnerability that the couple was exposed to from both internal and external factors of difference: a) internally, such differences were presented when couple's needs emerged as disagreements about the couple relationship's status and b) externally, with such differences being summed up by the pre-assessment form when the couple had to agree on their relationship status on each individual declaration form.  What such differences conveyed was the couple seeking a resolve to their relationship status and an agreement in the therapy room, however, the couple lack of agreement was a clear vulnerability manifested in anxiety around couple's relationship status. In seeking to overcome such differences, the couple showed resilience, ability to act in each other's best interests and for the best interest of their couple relationship.  It was later revealed during therapy sessions that one partner had proposed marriage to the other partner for the duration of their relationship, with such a negotiation yet to find resolve. Lack of agreement and or resolution on marriage proposal negotiation represented a crucial point of analysis for our couple client and it was termed as vulnerable and a wounded aspect of couple client that perhaps was not acknowledged as a present source of anxiety and difference between the two partners until asserted in the therapy room.

Determining factor of pragma love and couple therapy: what matters most?

 In above illustrated case, one main determining factor of couple's vulnerability was represented by  an unresolved or incomplete marriage proposal. Such aspect was then recognised by the couple client as a source of anxiety and then addressed and resolved in the therapy room. It was also clear that transitional period of retirement presented an obstacle of differences that were in fact traced back to its source of anxiety around the couple relationship status. The couple client's ability to identify and negotiate aspects of their relationship and positively resolve differences are significant aspects of what is termed mature love and pragma relationships. A question remains on whether or not what confers such a term to a relationship stays with the length of a relationship or the couple client's resilience and ability to negotiate over their differences when couple's vulnerability is revealed and psychological transitions are encountered.

The argument of this article is that a real pragma love relationship depends on a successful negotiation of factors 1 to 8 and yes, time is of the essence, however many months, rather than many years, suffice.