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The Care of the Individual

Juan Korkie, Clinical Psychologist

If I reflect on my years of practice, there is one area in working with couples that I have had to grow into deliberately. The balance between working with the pattern and attending to the individual within it.

More specifically, how to work with the partner whose level of emotional distress and activation makes the therapeutic process itself too much to tolerate.

Early in my work, I was far more strategic and technical. The focus was on the pattern, on restructuring the interaction, on intervening in the sequence. That remains central. But over time, my failures with certain couples forced me to confront a limit in that approach.

When one person becomes highly activated, the work does not just become difficult. It stops. The interaction can no longer be held, and that person can no longer remain engaged in it. Not because they do not want to, but because they are no longer able to.

That has changed how I think about the work.

The focus is still on the pattern, but it has to be balanced with creating conditions where each individual can remain present in the exchange. In some cases, that requires actively supporting one partner to manage their level of activation so that the work can continue.

I now pay much closer attention to differences in activation between partners, particularly when one person’s level of intensity far exceeds the other’s. In those moments, the issue is no longer only the pattern of interaction, but whether the interaction can be sustained at all.

The idea of the window of tolerance has been useful, but more importantly, I work directly with activation itself. I introduce it early. I name it in the room. I track it as part of the process.

Because spiralling intensity does not deepen the work. It breaks it.

There is a point beyond which increased emotional intensity no longer creates access, but shuts it down. Listening narrows. Language breaks down. The interaction reorganises around survival rather than engagement.

This requires a shift in balance.

The work is not only about intervening in the pattern. It is also about ensuring that both individuals remain within a range where participation is possible. Where needed, this means slowing the process, supporting regulation, and allowing the individual experience to be recognised so that it does not escalate and override the interaction.

At the same time, this introduces a tension that has to be managed carefully. Supporting one partner to regulate is not the same as shifting into individual therapy within the couple frame. The focus does not move away from the interaction as the unit of work. It remains anchored in what is happening between them. The individual is supported so that they can stay in the interaction, not so that their internal world becomes the primary site of the work.

When that boundary is not held, the work shifts. The focus narrows onto one person’s experience, the other partner becomes peripheral, and the relational pattern drops out of view. What appears as care can become a drift into individual therapy, leaving the interaction unchanged.

The distinction is functional. Support is used to restore participation in the interaction. It is brief, targeted, and always linked back to what is happening between partners. It does not replace the work. It makes the work possible.

This is not a move away from systemic practice. It is what allows systemic practice to happen.

Because the interaction can only be restructured if both individuals are able to remain in it.

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