Family Doctors can help couples to dig deeper and solve the problem at the core, rather than just fixing it on the surface

Following on to my last post about couple counseling, one of the most important trap or pitfall for many couples is the “primary, secondary, and tertiary emotional loop”. This will cause a lot of pain for these folks, leading to numerous biopsychosocial presentations in GP land.

When one party in the relationship feels at the “primary level”, the feeling of shame, not good enough, disconnectedness, unloved, uncared for, or loneliness, this will lead to the “secondary feelings” of fear, stress and anxiety.

Of course, at this secondary level of fear, stress, and anxiety, it often gets “contaminated” by other life stressors that adds to the fear, and anxiety. This includes the stress of work, finance, pandemic, and parenting children to name a few.

If these are unresolved, it will then lead to the “tertiary feelings” and manifestation of the fight or flight responses, including anger, being critical, blaming self/others, defensiveness, withdrawal or stonewalling. It will also increase the need or urge for distractions, like comfort eating, smoking, drinking, drugs, and gambling. This is to escape the emotional discomfort at this emotional level. These will of course, create more disconnection for the relationship, more fear, more fight or flight, more disconnection, and now we have the “primary, secondary, and tertiary emotional loop”.

To solve this, one must first become aware and break the cycle at all levels, with the primary level being the most important. It is often at the core of the issues. If one is not careful, one will focus too much energy at the tertiary and secondary level, because this is more apparent to us on the surface. Look deeper is the key message.

Do we as Family Doctors see that in ourselves and our patients? It’s a very human thing.