Interview of Dr. Charles Hershkowitz, MD, Imago therapist
on IMAGO therapy for couples Tell us about your background and training. I’m an American, born in New York, and started first on a scientific career there in Physics. Then in Belgium where I came to live, I got my ‘Licence en Sciences Physiques’ at ULB in 1969. Deciding to become a psychiatrist instead, I undertook medical school and then the psychiatric post-graduate cursus, both at ULB. I got my qualification as a psychiatrist in 1987. In psychotherapy, I trained in diverse disciplines and techniques, the most recent being EMDR. In 2002, wanting to help couples more effectively, I started training in Imago Relationship Therapy, developed by Harville HENDRIX, Ph.D. in the US since the late 80’s. You’ll learn more about IRT below. I’m a certified IRT practitioner since 2007. And what do you do now? I’ve focused on my private practice, which is in French and English in Woluwé St.Lambert. In the individual therapies, an important theme is how can this person understand and act upon his/her couple – or, with single people, their difficulty to get started in a relationship or stick to it when times get tough. As for couple therapy, it makes up more than half of my practice; sometimes I see couples with a female co-therapist. I’d like you to know that I’ve led, over the last five years, 15 of quite a special type of weekend workshop. 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. It was impressive and moving to see how the use of Imago tools helped all these very diverse participants feel safe enough to open up within the group to some of their deepest inner wounds. Opening up tho a old wound is the first step in curing oneself from its residual effects in one's life. For a couple in Imago therapy, how do sessions go practically ? 1) To start couple therapy, do both partners have to come to the first session ? I prefer that they do, but sometimes I accept first seeing one or the other or each of the two partners alone once. This can bring the more reluctant partner to know more realistically what the therapy will be like and so feel less threatened by it. Once the couple comes to sessions, it’s usually possible to conduct a therapy productively even if at home there is very little cooperation between the two. At the first session or two, some typical topics are : the difference between the partners as to their desire to consult (one being typically reluctant whereas the other is pushing for it), and how each partner relates to a structured and directive approach; how each one feels about their problems and interprets their meaning; the state of their sex life and whether there has been or is presently some infidelity. By the 3rd session, usually, the specific Imago tools are learned and applied to the problems. 3) What are some of your key themes once the therapy is under way ? the phasing-out of criticism in favor of other forms of expression; how empathy can be increased between them; when extreme reactions to minor events are tenacious, discovering the related childhood wounding and how it influences their relationship; how they can move towards trying out certain "tools" on their own between sessions.
on IMAGO therapy for couples
Tell us about your background and training.
I’m an American, born in New York, and started first on a scientific career there in Physics. Then in Belgium where I came to live, I got my ‘Licence en Sciences Physiques’ at ULB in 1969. Deciding to become a psychiatrist instead, I undertook medical school and then the psychiatric post-graduate cursus, both at ULB. I got my qualification as a psychiatrist in 1987. In psychotherapy, I trained in diverse disciplines and techniques, the most recent being EMDR. In 2002, wanting to help couples more effectively, I started training in Imago Relationship Therapy, developed by Harville HENDRIX, Ph.D. in the US since the late 80’s. You’ll learn more about IRT below. I’m a certified IRT practitioner since 2007. And what do you do now?
I’ve focused on my private practice, which is in French and English in Woluwé St.Lambert. In the individual therapies, an important theme is how can this person understand and act upon his/her couple – or, with single people, their difficulty to get started in a relationship or stick to it when times get tough. As for couple therapy, it makes up more than half of my practice; sometimes I see couples with a female co-therapist.
I’d like you to know that I’ve led, over the last five years, 15 of quite a special type of weekend workshop. 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. It was impressive and moving to see how the use of Imago tools helped all these very diverse participants feel safe enough to open up within the group to some of their deepest inner wounds. Opening up tho a old wound is the first step in curing oneself from its residual effects in one's life. For a couple in Imago therapy, how do sessions go practically ?
1) To start couple therapy, do both partners have to come to the first session ?
I prefer that they do, but sometimes I accept first seeing one or the other or each of the two partners alone once. This can bring the more reluctant partner to know more realistically what the therapy will be like and so feel less threatened by it. Once the couple comes to sessions, it’s usually possible to conduct a therapy productively even if at home there is very little cooperation between the two.
At the first session or two, some typical topics are :
the difference between the partners as to their desire to consult (one being typically reluctant whereas the other is pushing for it), and how each partner relates to a structured and directive approach;
how each one feels about their problems and interprets their meaning;
the state of their sex life and whether there has been or is presently some infidelity.
By the 3rd session, usually, the specific Imago tools are learned and applied to the problems. 3) What are some of your key themes once the therapy is under way ?
the phasing-out of criticism in favor of other forms of expression; how empathy can be increased between them; when extreme reactions to minor events are tenacious, discovering the related childhood wounding and how it influences their relationship; how they can move towards trying out certain "tools" on their own between sessions.
the phasing-out of criticism in favor of other forms of expression;
how empathy can be increased between them;
when extreme reactions to minor events are tenacious, discovering the related childhood wounding and how it influences their relationship;
how they can move towards trying out certain "tools" on their own between sessions.
What are the basic theories underlying Imago therapy ? Harville HENDRIX united four approaches and applied them to couples :
What are the basic theories underlying Imago therapy ?
Harville HENDRIX united four approaches and applied them to couples :
developmental psychology establishing the successive stages of maturity;
cognitive therapy with its structured, active styles of intervention;
neuroscience with its research on how brain regions influence behavior;
psychoanalytic theory with its emphasis on defense mechanisms and unconscious repetition.
His first book, published in 1988, “Getting the love you want” presents a synthesis and has a practical Appendix explaining how to proactively develop one’s couple without a therapist. It was a best-seller. In 1995, after his second book "Keeping the love you find", he published a short article on the essentials of theory and practice of IRT; the French translation: see here. Does your couple therapy use techniques a lot ? Yes, it 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. Three of these needs, on the speaker’s side, are: to be accurately heard; to be validated as having a personally meaningful logic (despite the differences from the logic of the other); to get a minimum of empathy from the other person when the speaker expresses a feeling. IRT has developed ways of speaking for each of the 2 communicators that target these 3 essential results and ensure that they are reasonably well attained. 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; the form, on the other hand, is coached by the therapist. The responses of the person listening are also coached. My coaching aims at obtaining results for the consulting couple which is in dire need of getting through to each other. A well-done I.D. produces a deeply peaceful, accepting feeling between the 2 partners who have long been at each other like cats and dogs. Feeling this way, even briefly, shows the couple that a new richness is possible and can help them to 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 mainly oriented to get them to experience even a short moment of real empathy because this may motivate them to believe again in their couple's potential, despite all the pain, and then commit to work more effectively than before on their relationship. Either a moment of empathy does not take place and the couple will remain separated, or it does happen and they 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: the behavioral challenge of developing new responses to each other when under stress and the cognitive challenge regarding how their “frustration machine” functions and where it comes from. When is a couple therapy really finished ? Consider an overview of the three typical stages of an Imago therapy. First stage (about 6-8 sessions): presentation of their difficult experience; learning of the Imago tools and application to their communication about it; during I.D.s, a few moments of empathy occur; when the individual past of a partner is occasionally touched on, a morsel of new understanding of emotional wounding is gained and the origin of the dovetailing of the partners’ patterns starts to be grasped. Second stage (around 6 sessions): more detailed discovery of unknown aspects of the partner; challenge of accepting these rather than having to exclude them (by negative judgments, etc.) as previously; the basic tools of I.D. plus more advanced ones, are used better and better; doing I.D.s at home between sessions becomes possible. Third stage: higher and higher level of problem-solving abilities; being cooperative when a relational difficulty arises sometimes takes the fore over becoming mainly adversarial; relational “trouble” sometimes is felt to be an opportunity to learn something ; flexibility under stress increases; the full, true self of each partner comes out, including the most ‘negative’ aspects, with less fear of rejection or break-up; acceptance of the otherness of the partner becomes a new norm; depth and strength of commitment grows as the couple gets through difficulties faster and more durably. (interview replies updated Jan. 2013) Dr. Charles HERSHKOWITZ, MD 1200 Brussels, Belgium + 32 470 / 400 110
His first book, published in 1988, “Getting the love you want” presents a synthesis and has a practical Appendix explaining how to proactively develop one’s couple without a therapist. It was a best-seller. In 1995, after his second book "Keeping the love you find", he published a short article on the essentials of theory and practice of IRT; the French translation: see here. Does your couple therapy use techniques a lot ?
Yes, it 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. Three of these needs, on the speaker’s side, are: to be accurately heard; to be validated as having a personally meaningful logic (despite the differences from the logic of the other); to get a minimum of empathy from the other person when the speaker expresses a feeling. IRT has developed ways of speaking for each of the 2 communicators that target these 3 essential results and ensure that they are reasonably well attained. 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; the form, on the other hand, is coached by the therapist. The responses of the person listening are also coached. My coaching aims at obtaining results for the consulting couple which is in dire need of getting through to each other. A well-done I.D. produces a deeply peaceful, accepting feeling between the 2 partners who have long been at each other like cats and dogs. Feeling this way, even briefly, shows the couple that a new richness is possible and can help them to 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 mainly oriented to get them to experience even a short moment of real empathy because this may motivate them to believe again in their couple's potential, despite all the pain, and then commit to work more effectively than before on their relationship.
Either a moment of empathy does not take place and the couple will remain separated, or it does happen and they 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: the behavioral challenge of developing new responses to each other when under stress and the cognitive challenge regarding how their “frustration machine” functions and where it comes from.
When is a couple therapy really finished ?
Consider an overview of the three typical stages of an Imago therapy.
First stage (about 6-8 sessions): presentation of their difficult experience; learning of the Imago tools and application to their communication about it; during I.D.s, a few moments of empathy occur; when the individual past of a partner is occasionally touched on, a morsel of new understanding of emotional wounding is gained and the origin of the dovetailing of the partners’ patterns starts to be grasped.
Second stage (around 6 sessions): more detailed discovery of unknown aspects of the partner; challenge of accepting these rather than having to exclude them (by negative judgments, etc.) as previously; the basic tools of I.D. plus more advanced ones, are used better and better; doing I.D.s at home between sessions becomes possible. Third stage: higher and higher level of problem-solving abilities; being cooperative when a relational difficulty arises sometimes takes the fore over becoming mainly adversarial; relational “trouble” sometimes is felt to be an opportunity to learn something ; flexibility under stress increases; the full, true self of each partner comes out, including the most ‘negative’ aspects, with less fear of rejection or break-up; acceptance of the otherness of the partner becomes a new norm; depth and strength of commitment grows as the couple gets through difficulties faster and more durably. (interview replies updated Jan. 2013) Dr. Charles HERSHKOWITZ, MD 1200 Brussels, Belgium + 32 470 / 400 110
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