1. Interviewing the Internalized Other Part 2: applied in couple work Workshop for OAMFT in Toronto 2 November 2012 by Karl Tomm MD

3. depressed angry

6. blaming and diminishing the other blaming and diminishing the self affirming and crediting the self affirming and crediting the other PIP HIP

8. Introduce the idea as ‘an experiment’ to enhance empathy by activating each partner’s awareness of the experiences of the other. Explain that: 1)As we interact with someone repeatedly, we automatically create an impression of that person within ourselves, including their thoughts, feelings, desires, intentions, etc.; 2)Over time, this impression grows into a complex image to become an ‘internalized other’ which is part of the self; 3)The internalized other within the self is never exactly the same as the ‘actual other’ but there will be some overlap or congruence between them; 4)It is often helpful to become more aware of which thoughts and feelings of one’s internalized other fit the experiences of the actual other, and which do not; 5)This phenomenon can be explored by interviewing one person as if he or she were ‘the other’ in the presence of the actual other, and then discussing the similarities and differences between the internalized other and the actual other.

9. Ask if the couple would be willing to give it a try, and then who would be willing to go first (unless there is a particular reason to suggest one partner should start). For this outline, assume a husband, John, volunteers to be interviewed as his wife, Ann. 1)Inform John that you would like to talk to him as if he were Ann and that he should respond to your questions from his experience of her experience speaking from the ‘I’ position of Ann; 2)Acknowledge that he cannot know exactly what she thinks and feels inside, but that he has some intuitive hunches about what may be going on for her, and that you want him to respond from those hunches, i.e. about her inner experience, not to role play her outer behavior; 3)Ask the actual Ann to listen and reflect on both your questions and John’s answers, indicating that you will ask her later about her inner responses in comparison to John’s responses (perhaps offer Ann a pen and pad of paper to take notes during the experiment if she wishes).

10. Begin to interview ‘Ann’ as an internalized other within John: 1.Look at and speak to John but address his internalized wife, ‘Ann’, using her name repeatedly; 2.Start with simple questions to ‘Ann’ about her recent or current experience; 1.“Ann, how did you feel about coming to today’s meeting?” 2.“Ann, how do you feel about how our session is going so far?” 3.Shift to ask ‘Ann’ what she admires and respects about John; 1.“Ann, what is it about John that you respect and admire the most? 2.“What else do you admire about him as a person?” 3.“What was it about John that drew you to him in the first place, Ann?” 4.Explore the relationship between the John and Ann from ‘Ann’s’ perspective, moving from what is valued to what is of concern; 1.“Ann, what is it that you already have in your relationship with John that you value and want to preserve, and perhaps even strengthen? What else?” 2.“Ann, what is it in the relationship with John that you are the most worried about? What else?” 5.Enquire about the perspective of others regarding the relationship between Ann and John and how they are affected by it; 1.“Ann, what concerns do other family members have about your relationship with John? … And how are your kids being affected by your current relationship with John?” 2.“Ann, what worries do your closest friends have about your relationship with John?”

11. Continue interviewing ‘Ann’ as an internalized other within John: 1.Enquire about ‘Ann’s’ needs and desires; 1.“Ann, what is it that you need the most at this time in your life?” 2.“What are some of your unfulfilled desires?” 3.“Ann, what would you like from John in particular?” 2.Refocus on John, this time on possible changes he could make that ‘Ann’ would appreciate; 1.“Ann, suppose John were willing and able to make changes in the way he relates to you, what single change would you appreciate the most?” 2.“Let’s say John was willing and able to make further changes, what other changes would you appreciate, Ann?” 3.Ask ‘Ann’ what exactly John would be doing differently if he were to make those changes; 4.Ask ‘Ann’ what other relevant issues might be useful to explore in order to better understand her relationship with John (and follow any leads with reflexive questions). 5.Thank ‘Ann’ for her thoughts and feelings, and say “goodbye”

12. Resume interviewing the actual John: 1.Welcome John back into the conversation; 1.“Thank you for trying to speak from ‘Ann’s’ experience” 2.Ask John what the experience of being interviewed as ‘Ann’ was like for him; 1.“How was it for you John, trying to speak from ‘Ann’s’ experience? Was it more difficult than you expected, or easier than you had imagined?” 2.“If you were to estimate, on a scale of 1 to 10, with 1 being unable to get into her experience at all and 10 being fully into her experience, how far do you think you were able to allow yourself to go?” 3.Ask John to give his honest estimate of the percentage of congruence between his answers as ‘Ann’ and the answers that the actual Ann was giving to herself while she was listening. 1.“What percentage of the answers that you gave speaking as ‘Ann’ do you image resonated with the actual Ann, and she was probably thinking ‘that’s about the way I feel’?” 2.“And what percentage do you image she might have been thinking ‘No, no, it’s quite different than that’?”

13. Turn to the actual Ann and address her directly: 1.Ask Ann about the percentage of congruence that came to her mind; 1.“Ann, what percentage of agreement in responses came to your mind, before John offered his guess?” 2.Ask Ann if there was anything in the percentage that ‘fit’ for her that she was actually surprised that John had understood her so well in answering “correctly”; 3.If there were no surprises, ask Ann what, among the all the answers that fit for her, she was most pleased that he understood about her experience. 4.Turn very briefly to John and ask him if he is interested in hearing about what responses didn’t fit for her, and that Ann would have answered differently. 5.If yes, ask Ann to clarify the main issues where John was ‘off the mark’ and what she would have answered quite differently.

14. Return to John: 1.Ask John if he understands the difference between Ann’s actual experience and his experience of her experience; 2.If not, encourage John to explore and clarify any confusion or incongruities with Ann; 3.Ask Ann if she feels he now understands the difference between how he responded and her actual expeience; if not, seek further clarification 4.Ask John which questions he had been asked as ‘Ann’ that he did his best to answer, but Ann had not yet commented upon, that he would appreciate hearing her respond to. 5.Invite Ann to respond to his curiosity about how she would have responded to those specific questions 6.Suggest that further wonderings might come up for them after the session (i.e. about Ann’s experience and John’s experience of her experience), and if so, encourage them to feel entitled to clarify these issues with one another

15. If time permits, reverse the whole process and interview ‘John’ within Ann using a similar sequence. Alternatively this could be done in a subsequent interview, or left out, depending on the clinical situation. K. Tomm Revised November 2012