Interview of Dr. Charles Hershkowitz, MD,
Imago Relationship Therapist

 

Tell us about your background and training.

I’m an American from New York, and started first on a scientific career there in Physics. Subsequently I came to live in Belgium & in 1969 got my ‘Licence en Sciences Physiques’ from ULB. However, I decided to leave pure science to become a psychiatrist and psychotherapist instead; I went through medical school and then psychiatric post-graduate work in ULB-associated hospitals, & qualified as a psychiatrist in 1987.

 After starting training in 2002 in Imago Relationship Therapy or IRT (www.ImagoRelationships.org , or also click here for a brief summary), I was certified as IRT practitioner in 2007. I also have trained in various other psychotherapy methods, the most recent being EMDR and Voice Dialogue (www.VoiceDialogue.org ).
 

And what do you do now?

I’ve focused on my private practice, which is in French and English in 1200 Brussels (Woluwé-St. Lambert). In the individual therapies, an important theme is how can this person understand the deeper personality roots which influence how he/she acts in intimate relationships and possibly make changes on some level. With single people, I often work on their difficulty to get started in a close relationship or remain committed when the going gets rough. As for couple therapy, it makes up more than half of my practice; occasionally  my wife Doris, who is also trained in IRT, works with couples at my side.

I’ve led, over the last five years, 15 weekend workshops. These mix singles with people in a couple but coming alone. They help participants identify the early emotional wounding which is very pertinent to their difficulties in couplehood, and start loosening the hold of this wounding on their present lives. It was impressive and moving to see how the Imago tools helped all these very different participants feel safe enough to open up within the group to some of their deepest inner wounds and then started taking practical measures to distance themselves from the behaviors stemming from those wounds.


For a couple in Imago therapy, how do sessions go practically ?

Q. To start couple therapy, do both partners have to come to the first session ?

A. Usually yes -- but sometimes it’s better first seeing one or the other or even both partners alone once. This can bring the more reluctant partner to know more realistically what the therapy will be like and so feel more safe when the first couple session occurs.

Q. What happens then ?

A. During the first session or two, each partner tells his/her version of what’s wrong and why. As  I hear each partner’s story, I attune my receptivity in order to embrace their 2 very different worlds as much as I can, and rephrase what I’m hearing in order to check whether I’ve gotten the person right. This helps develop safety for the person speaking, and decreases the natural tension, anxiety and often shame at vulnerably sharing one’s “dirty linen” with a stranger.

By the 3rd session, the specific Imago tools start being learned and applied. Most of the session time (N.B.: couple sessions are an hour and half long) is now spent with the partners face-to-face as I coach them to deal very differently with what they choose to expose.

Q. What are some of the typical themes which are worked on face-to-face with these tools ?

A. Here is a partial list, but themes vary quite a lot among couples :

   Criticism and how can it be phased out by other forms of expression ?

   How can deep empathy between them return despite all the distancing ?

   When very high reactivity to “small” triggers keep occurring, what childhood  wounding is showing itself and just how does it influence behavior patterns ? 

   What’s gone wrong with sex and how might its quality be restored

   What was going on unconsciously at the time of their choice of each other, and how have certain negative behaviors developed and locked in from that choice ?

   How can the new "tools" experienced in sessions be used on their own at home ?
 

How important are techniques in what you do ?

IRT does use specific procedural instructions regarding communication more than most other therapies. 
Here’s why. Most conversations between two people neglect how key it is to meet several basic human needs in order to have a truly satisfying result for both. Three of these needs, on the speaker’s side, are: 1) to be accurately heard; 2) to be validated as having a personally meaningful logic; 3) to receive empathy from the other person when vulnerably expressing a feeling.

IRT has developed ways of speaking for each of the 2 communicators that target these 3 essential results. The name given to this way of speaking is Intentional Dialogue or Imago Dialogue (I.D.).
The content expressed by the partner speaking in an I.D. is quite free, whereas the form is coached by the therapist. The ways of responding by the partner listening are also coached. The coaching targets a rapid decrease of suffering for both partners.
Following the ground rules of an I.D. will typically result in a peaceful, accepting feeling between the partners. Feeling this way helps the partners believe again in their couple.

If a couple has separated or is close to doing so, does getting them back together again mean your therapy has been successful ?

When separating partners come, I am oriented to get them to experience a moment of deep empathy because this may motivate them to believe again in their couple's potential, despite all the frustration and pain, and then to commit to get to work on their relationship.

Either a moment of empathy does not take place and the couple will tend to concretize their separation or divorce, or it does happen and they may decide to “give it another try”. In the latter case, a sort of pre-therapy will have been successful, but the “nuts and bolts” still have to be worked through : developing new behavioural responses to each other when under stress and the cognitive challenge of figuring out together how their “frustration machine” functions and where it comes from.

When is a couple therapy really over ?

Here’s an overview of the three typical stages of an Imago therapy (N.B. session frequency = 1/ 2-3 weeks):

First stage (about 5-6 sessions) : presentation of their difficult experiences with each other; learning the Imago tools and the I.D. and applying it to communicating about these experiences; during I.D.s, a few moments of empathy occur; when the individual past of a partner comes powerfully up when working on a present problem, new realizations are gained about the emotional wounding each is carrying into their relationship,.

Second stage (about 4-8 sessions) : more detailed discovery of unknown aspects of the partner; challenge of accepting these rather than excluding them (by negative judgments, etc.) as previously done; the basic tools of I.D. plus more advanced ones, are used more skillfully; doing I.D.s at home between sessions becomes possible; awareness increases of what the choice of this particular person for a long-term relationship means.

Third stage : higher and higher level of problem-solving abilities; being cooperative when a relational difficulty arises sometimes takes the fore over being automatically adversarial; a conflict sometimes is felt to be an opportunity to learn something; flexibility under stress increases; the full, authentic self of each partner comes out, including ‘negative’ aspects, with less fear of rejection or break-up; acceptance of the otherness of the partner becomes a new norm; strength of commitment grows as the couple moves through difficulties more fluidly.