Episode 9 Coffee Chats: Katie Tesensky Conn, LMFT on Couples & Family Therapy

In this episode of Coffee Chats, Ramya talks with Katie Tesensky Conn about self-care as a couples therapist, repair conversations, and how couples therapy can play a role in your relationships.

Curious to hear more? Listen to Katie’s previous discussion with Sara here.

Interview transcript {edited for clarity}

Ramya (she/her): Hello, everyone. Welcome back to our Coffee Chat. Today we have Katie, clinician at Room to Breathe. I will let her introduce herself, and then we'll see how our conversation goes.

Katie (she/her): Yes. Hello everybody, like Ramya said, my name is Katie. I am a marriage and family therapist here at Room to Breathe. I've been with the practice for, I think, almost eight years, so I've been here for a while, and it's been great.

I see a lot of couples. I also see individuals and some families too, but couples work is kind of my bread and butter. Relationships in general are my bread and butter, even if it's with individuals. So, yeah, I went to Adler, got my degree there, and then have been in private practice pretty much ever since. So yeah.

Ramya: Yeah, you and I have that Adler connection, which I didn't realize when I first started here. 

Katie: Yes, yes. 

Ramya: That's wild. So tell us a little bit about your journey into like, doing relationship work and couples work, and why you chose that. 

Katie: Yes. Well, like I said, my degree is in marriage and family therapy, so a lot of my schooling, or a lot of my classes in grad school were very focused on that type of work, and like working with systems and seeing almost the relationship as the client versus individual people.

But I was interested in that because I knew that, like that was just more, I don't know, I guess, how my brain worked in a way. I knew that I didn't just want to be working with individuals, and I knew that I -  having diagnoses and having to, like, fit things into that box didn't really like jive for me. I was just like, okay, sure, so you have anxiety. Okay, like, there's validity in that absolutely. But I don't want to just treat your anxiety, what else is going on? So I kind of, I try to see people as their full human self, and not just that diagnosis.

Ramya: Holistically. 

Katie: Totally, yeah. 

Ramya: I think that's very much how we work as a practice, too. Of like, not just symptoms and diagnoses, but rather, let's look at the whole picture, because you're a whole human being. 

Katie: Exactly, exactly. So that's kind of what made me just more intrigued about working with couples, working with families. Obviously, individual work is wonderful and great, and although you can only do so much with one person in the room…so, right, bringing more people in. I mean, granted, it can sometimes be a lot, but I have found that you can get a lot more done because you have more people. There's more change that's possible. I have my more people in the room, and again, it can be daunting, but it's also, yeah, wonderful though it is exciting in a way. 

Ramya: Yeah, I've, you know this, I've dabbled a little bit in couples work, but haven't really done much like family work. What's it like…for me and for our listeners, what's it like to work with a whole family where there's like, more than two people in session? 

Katie: It's - the sessions go very fast. I will say that, but again, I find it to be pretty powerful, because there's no room for error, meaning, like there's no game of telephone that's being played. Like everyone's hearing the same thing. Everyone is getting the same information from one another, from the therapist, and again, it just, there's such a…there's more room for change that can happen when everyone's there.

It can be difficult and challenging, because it's like, oh my gosh, the whole family is here. Being vulnerable is hard to one person, let alone your family. But if there have been instances of, you know, like emotional wounds that have happened in family relationships, those can be tended to in a family therapy setting. It may take some like working up to get to those moments of being vulnerable saying, you know, hey, this is how how my feelings were hurt. This is what happened. How I, again, this is my emotional reaction. But being able to have those conversations in a place like…truly in a safe space, it has the potential to be really healing. As cliche as that sounds, but I mean, it's true, like this is another place where someone can be like, we can really sit in the emotion, and someone can, you know, hopefully, really hear it and take it in and do the work to prepare. 

Ramya: Yeah, I think you said this earlier, but that sounds super powerful, too, and helpful thinking about it as like the clinician, because there so many times in individual sessions where you're like, I would love to hear the other person involved in this too so I have a whole picture of everything that's going on. Because oftentimes we only hear a part of it, right? 

Katie: Right, right, right. And we're all biased to our own experience of things. So we look at things through that lens. So having more people in the room obviously gives more context to the situation, but it highlights how other people are interpreting information, perceiving things. I mean, all of like, what their emotional reaction is because maybe they didn't say it in the moment. So it's just like a richer conversation that can happen and, right, arguably a bit more powerful from, like, a therapeutic standpoint. 

Ramya: Yeah, for sure.

Tell me about like, any specialties or, like, any specific areas of interest within your work that you have. 

Katie: Yeah, so I, like I said, I mean, working with both individuals, couples and families, I utilize a lot from Emotionally Focused Therapy, which was originally for couples, although it has been adapted to work with individuals too, and it's looking more at like, what are the deeper emotions that are at play, that are - at least this is how I interpret it, how I've used it in my sessions - but like trying to understand the deeper emotions that are at play and that come up in conflict at the present moment, and also then, how are those connected to different lived experiences from our past as well. Because a lot of times, what I found with couples that regardless of what the conflict is about, there's usually a pattern to it. There's usually similarities. Again, regardless of what the actual argument is.

Ramya: Say more about what you mean when you say patterns like, what are the kinds of things that come up? 

Katie: Yes, so one of the most common patterns with couples. I'll just talk about couples specifically for a minute. So - is this pursuer/withdraw dynamic. So let's say one partner is, you know, wanting to be heard, wanting to…I mean, most people want to be heard, understood, but maybe one person gets a little bit louder. They want to resolve or talk about the conflict right in the moment, resolve it right in the moment. They just want to do all of that right away. Usually they're falling into the pursuer kind of bucket, if you will. But here's the thing, the more that they pursue, the more that they're like, let's figure it out. Let's do it. Let's address this and resolve it. The other partner, who may withdraw because that might be very emotionally intense for them, they may need some more time to just internally process what's going on. Figure out how they're feeling. How are they thinking about this? What does this all mean? That might take a little bit of time. And also the initial reaction might be just shut down. I can't do this, again, withdraw. The more that again, the pursuer pursues, the more the withdrawer is going to withdraw. So it has this feedback loop that doesn't really serve us very well, and it's super common. I mean, majority of people will find themselves in this situation and…but, right, working with couples. I mean, there's many things that you can do to disrupt this pattern, but really that one of the first things to do is to learn it, know it like the back of your hand, so you can catch it in the moment and then do what you know you both need to do individually to, kind of, tend to your own individual reaction to things. 

Ramya: Yeah, I've never heard that before. I also have not super knowledgeable on Emotionally Focused couples therapy or family therapy. So that's super interesting. 

Katie: And that's just one. There's a couple others. 

Ramya: Yeah, yeah, I imagine so. No, that's a great example.

I think another question I had for you is just about how you were talking about how going into like marriage and family therapy and working with couples and relationship stuff was really like, what you vibed with, if you will, learning in school, and how diagnosis and just the symptoms wasn't really your cup of tea. I feel like something people don't take into consideration is that our choice of perspective and therapeutic orientation is just as much personal as it is professional. And I'm wondering how you like balance that a little bit because we have our own relationships and our own journeys that brought us here, as well as holding space for other people. 

Katie: Yes, totally. It's…some days are easier than others to manage that stuff, and that's mostly based on like, what's going on in my personal life, not even coming up for clients and things like that. I will say, yeah, working from home, that's also been an interesting, like challenging piece to this, because I really didn't realize how much I appreciated the commute to and from the office to decompress.

Ramya: Oh, yeah, that's, that's a big one. 

Katie: Yes, especially because I would, I mean, my commute was partially going down Lake Shore Drive and seeing the lake and seeing people run and bike and…I mean, obviously I think of it, like, very nostalgically now. I'm sure in the moment, sitting in traffic, maybe not, not the case. But, it was just like a nice decompression time for me, and now my decompression time is like maybe 30 seconds as I walk down the stairs. So a little bit different.

I think, too, being more of an EFT therapist, you're bringing a lot of your own self into the room, meaning you're really like, mirroring and modeling what people are bringing in and their emotional reactions to things. So if it's like, okay, yeah, this was a really scary experience, or this was really sad and upsetting to me, you're obviously not feeling those emotions, but you're mirroring it back and saying, like, I see how upsetting it was to you, I see that this was really challenging and difficult, and so that takes another skill or muscle, because you're really present there. I mean, we all should be present there, but you're really, really present in sitting with clients in very emotional spaces and also helping clients get to that emotional space too. So I mean, you know, there's always room for growth in our own self care practices, even as therapists.

Ramya: No, of course, we're whole humans too, 

Katie: Right, right. And I'm not perfect at it at all, but, I mean, I try to get outside as much as I can, even if it's like cold or just as a little bit of a change of scenery, change of pace, that's helpful for me. And trying, I mean, again, there's some room for improvement there. But, you know, just trying to, like…

Ramya: We’re all works in progress. 

Katie: Yes, yes, but trying to compartmentalize work as much as I can of like, okay, that's work when I shut, you know, I literally closed my computer. That's like me taking off my therapist hat, and I can then just be Katie and go about my day. 

Ramya: Yeah, I when I've done some couples work, I find it a little more emotionally tiring for me personally, because there's now two other people in the room, but like you said earlier, like the relationship is really the client. 

Katie: Right.

Ramya: How does that really differ from maybe individual work and relationships? 

Katie: Yeah, so, I mean, right, seeing the relationship as more of the client…so thinking, I mean, it's kind of the simultaneous thing of like zooming out, thinking about things big picture, but then also understanding the nuances of, okay, this is what partner one is bringing to the table. This is what partner two is bringing to the table. And how are those things intersecting with one another? 

So, I mean, a very common example is just like, obviously, two different people, two different upbringings, two different lived experiences. Again, we're bringing those to the relationship. So it's trying to, again, like, look at those things with a, I don't know, with a certain amount of detail, but then also thinking about it big picture of, like, okay, but is this, I don't know. Like, is this what you want for your relationship? Is this what you want for your family? Because there is power and choice and, again, different values and things like that. But again, you're trying to, like, thread this needle of, oh, we've had, I don't know, I've experienced trauma pre my relationship but this is how that this trauma shows up in the relationship too, because it is part of me. So it's kind of the way…I equate it to some people, is it's like doing that silly thing as a kid where you're like, patting your head, but you're like, trying to rub your stomach at the same time, where you're like, This is hard. I'm doing two different things at the same time.

Ramya: And from a client's perspective, I'm sure it's a lot of hard work for them too, because there's always vulnerability in coming to therapy and sharing things. 

Katie: Absolutely. 

Ramya: And I imagine there's another layer of that too, in couples and family therapy, if you're showing up with multiple partners, if you're showing up with your family, if you're showing up just with one partner, whatever that might look like, right? 

Katie: Right, right.

Ramya: There's an added layer to that. Something that I've always been curious is, how do you leave it with your clients for them to be able to get on with the rest of their day or the rest of their week after having been in such a vulnerable position in session? 

Katie: Yeah, it's a good question, because sometimes it's easier said than other sessions. Sometimes it's like, okay, we aren't able to wrap things up as much as I would like to, you know, we aren't able to have, you know, a nice, pretty bow on top of everything.

A lot of times when people are talking about conflict specific things, I will try my best, and I will reiterate this a lot of like, we are not in this argument right now. We are talking about it, you know, maybe feeling similar emotions to when the conflict took place, but we are not in it right now. And I will preface that. I will end with that. I will sprinkle it within the conversation too. Sometimes it's, you know, strikes a chord. Other times it's like, right we're not in that place. Everything's okay. 

But it's hard. It's hard because they're, you know, I'm pushing, gently, pushing people to be vulnerable and open, and right, there's a need, then, to kind of close things up in a way that, you know, you aren't feeling totally emotionally raw at the end of our sessions. And a lot of times people do find that they talk about things, you know, maybe after the session, after we end, or later on in the day. And it seems like those conversations are helpful. I don't always encourage them, depending upon what is going on. But they sometimes can be helpful, because there's been a little bit more of guided, like a guided conversation that probably happened when we were all talking, that it gives like there's just a little bit more room to have more of a repair conversation. Obviously, I try to do those in session too. Again, sometimes people are sometimes people are ready for them. Other times they aren't. They sometimes need some time and space. I will also ask that, too, of: okay, what do you - if we've had a particularly intense session - I will ask people what they need individually, take care of themselves, if they're ready for a repair conversation, or if they need some more time and space.

So it just kind of varies, but again, sometimes it's easier than other times. 

Ramya: No, of course, as I think with most therapy experiences like couples and family or not, like we go to therapy for an hour a week or every other week, and then we have a whole life that we're existing in outside of just this vacuum space of therapy. And so I think our jobs as clinicians is a little difficult of, how do we wrap that up in a way where we're leaving people with things to reflect on and things to work on, while also understanding that we all have lives that we need to be functional for. And that's something that I think I've always found, I wouldn’t say difficult but challenging, when working with couples or families outside of individual work. 

Katie: Yeah, yeah. And I will say a lot of times too to couples, families, of like this, right, one hour that we're meeting this week is not…like more work is needed outside of here too, but work meaning like, how are you connecting? How are you having fun together? How are you also talking about the hard things? Because it's - right, one hour goes really fast, especially when people are in the room. And as much as…I mean, this always sounds silly, but I hope that there is a time where a couple, family, individual, where they don't need me. That they are able to, kind of graduate, if you will, from therapy, and take the tools and things that they've learned, because that's, I mean, that's growth, that's progress. And, of course, different life events come up. My door is always open, but it's like, great. There can be benefit in - okay, let's see how we can use these tools right in our daily lives.

But yeah, what's required of that is doing some work, putting forth some effort, prioritizing things outside of that one hour a week. 

Ramya: I had, I think it was a dance teacher one time, told me that we could use dance class as the place to practice, or we could use class as the place to learn new skills and then practice on our own time. And that's something that I'll often leave clients with too of like, we can practice our skills in session too, and there's value in that, and that's helpful. And, if we're wanting to, like, learn new skills or do more healing, and like learn how to have these healing conversations or repair conversations, then there needs to be some input into that outside of session, too. That's just what that reminded me of while you were saying that. 

Katie: Yeah, no, that's a perfect, that's a really good analogy, because it's like, I mean, it's just like with anything, any learning of new material, new skills, it's like, we need to put forth some time and energy towards that. And yeah, it requires those things. 

Ramya: Yeah. I'm just curious, what does…did you call it a repair conversation, or, like a healing conversation? 

Katie: Yes, yes, repair conversation. 

Ramya: Yeah, what does that typically look like?

Katie: Good question. So in my mind, the repair conversations are usually, obviously take place after an argument has occurred, ideally when both people have had some time to emotionally regulate, decompress, so they're not in a heightened state. Usually, when we're in the heightened state, when we're angry, I mean, we're not gonna get to that place of resolution. It's just not gonna be productive. 

Ramya: Sure. 

Katie: So usually, I recommend that people will take a little bit of time and space from one another, and then check in to see if both are ready for the conversation to resume, but with the intent of, okay, let's repair this. Sometimes it's a challenge, though, because a lot of people can get into the mindset of like, well, I was hurt first. I don't want to have to be vulnerable or go first. Or, I mean, it feels very risky to do, especially if people are not feeling heard, not feeling understood, it just feels scary.

And yet, though, in order to receive or get that understanding, feeling heard, feeling supported, we do have to tell the other person how we are feeling. The key to that is more of the I statements, the talking about your own experience of those things versus you did that, you did this, or you made me feel X, Y, Z thing. So there's a level of…what's the right word, I guess, intention around that, and really thinking…what made me upset, and how I was upset, and trying to use as emotionally - not charged per se, but just emotional language to describe those things.

So usually, you know, one person will say how they were hurt. The hope is that the other person can not only apologize, but just provide that level of understanding, accountability, of like, yeah, I am sorry that that happened. I'm sorry that I yelled, I'm sorry that I said something that hurt your feelings, because that wasn't, not only was it my not my intention, but like that, I never want to hurt your feelings. I don't. I don't want to do that. And then hopefully that, then, like, reverses the other way, where the other person can also say how they were impacted by, I don't know, whatever the issue was, whatever the conflict was about, and the other person can also provide that level of responsibility, accountability, understanding, and then we can get to a place of, okay, the other person hears me. They get it. And I also know, and sometimes this is more overt versus covert, but I know that they have my back at the end of the day, because really, that's all we want, is to know that my partner has my back. My partner's right next to me. You know, they're not the opposition in any way. 

Ramya: Yeah, bringing that back to, I think, comfortability and safety and whatever that looks like for that relationship or that couple, entity, exactly. 

Katie: Exactly, because, right, we all just want to feel safe in our relationship.

Ramya: Yeah. Okay, last question here before we wrap up, people often have a little more apprehension I find to get into doing couples work, relationship work, family work, as opposed to maybe just doing individual work. What would you say to people to get them to come in that might be like, on the fence about whether to start doing it?

Katie: Yeah, that might a little bit hesitant.

Ramya: Yeah.

Katie: I would say, give it a try. I would also say that finding the right therapist for you is going to be important too, because it is…right , there's a level of vulnerability that is encouraged, arguably necessary, to do this type of work, but it doesn't…I think this is there's a huge misconception, though, that like going to couples therapy means that your relationship is doomed, or it just means that you're going to break up, or that you only go to couples therapy when things are really, really bad. And while when things are really, really bad, there's still, you know, positive things that can come like, there's still work to be done. There's still things that that we can do. There's a huge benefit to the having that type of support and kind of those tools in the back of your pocket to rely on earlier, so you can kind of develop those skills, have that support, so that when life does throw you some curveballs, you can, you know, maybe handle it in a way that isn't going to completely, you know, rock the ship that is your relationship. 

So there's many layers to this, the answer to this question, but, I mean, I would, again, I would encourage people to try it, because there's a lot of, obviously, I'm super biased, but, like, there's a lot of joy and happiness and fun that can come from couples work because you're doing it with your partner. I mean, that is a bonding experience in and of itself, and we don't always, I mean, spoiler, we don't always talk about hard things. We don't always talk about the challenges. I mean, I love hearing about the successes and just like the fun things that people do to bond and that they do with their relationship and how they connect and all of those things are those are usually the reasons why we want relationships and why we want to stay in relationships in the first place. So, also, there’s a huge benefit in reflecting on those things and bringing that to the forefront cause I think, again, oftentimes we think oh, couple’s therapy, things are really bad. No, that’s not always the case.

Ramya: Yeah. Kinda like stretching a muscle or going to the gym or doing whatever. Like a lot of those kinds of things can be proactive and just maintenance and not necessarily putting out fires if you will. 

Katie: Right, exactly. Yes, exactly. 

Ramya: Well, thank you so much for our conversation today, Katie. I think I learned a lot. I hope our viewers get something out of it too.

Katie: Yes, me too. 

Ramya: Let’s see. I think that was it. Was there anything else that you really wanted to bring up that we didn’t cover today? 

Katie: No I don’t think so. I mean if people have questions about it, feel free to reach out to me. I have a few openings if clients or people are like oh, this could be something interesting to work on or learn more about. So, yeah, happy to help in whatever way I can. 

Ramya: And as always please respond on our social media pages or lookup our webpage, ask questions, and we’ll see if we can do some more of these too. Thanks, Katie.

Katie: Thank you.