PACT Couples Therapy in California & New York
PACT (Psychobiological Approach to Couples Therapy) is an attachment-based couples therapy model developed by Stan Tatkin, PsyD, that combines neuroscience, attachment theory, developmental psychology, and the biology of human arousal to help couples build secure, connected relationships.
Patricia Lamas Alvarez, LCSW, is the founder of Securely Coupled and has completed PACT Level 3 training. She currently coaches level 1 and Level 2 PACT within the PACT institute. She provides PACT couples therapy in person in Los Angeles and virtually throughout California and New York, helping partners strengthen secure functioning, navigate conflict, rebuild trust, and create lasting connection.
What Is PACT Couples Therapy?
PACT, or the Psychobiological Approach to Couples Therapy, is a couples therapy modality developed by Stan Tatkin that draws from attachment theory, neuroscience, developmental psychology, and the biology of human arousal. PACT focuses on helping couples recognize their patterns in real time and build greater safety, mutuality, and secure functioning by becoming experts on one another.
A relationship doesn't come with a built-in purpose or agreement. It's imagined and co-created by the two people in it. Each partner enters with their own unspoken understanding of what betrayal looks like, what love looks like, and what responsibility looks like, and often none of it gets discussed until problems arise. In PACT, couples draft an explicit ethos for their relationship and learn to negotiate real, win-win agreements that support safety and security going forward. Along the way, couples also learn how to argue better, and to understand both their own and their partner's triggers, and where those triggers originally came from.
Who PACT Couples Therapy is For
Couples in a new relationship who want a strong foundation from the start
Long-term partners looking to reignite connection and break unhealthy patterns
Couples preparing for marriage or deepening commitment
Partners working through trust issues, betrayal (affairs & others)
Couples adjusting to major transitions, such as parenthood, relocation, or career change
Intercultural or interracial couples navigating differences in background, upbringing, or family expectations
Blended families and couples merging households, parenting styles, or children from previous relationships
Any relationship configuration, including monogamous and consensually non-monogamous couples
Couples working through a potential deal breaker, or deciding together whether to stay or end the relationship
Couples navigating separation, divorce, and coparenting
3.The Biology of Human Arousal What it is: The moment-to-moment ability to manage your own energy, alertness, and readiness to engage. In PACT: Your body's stress response often drives conflict more than the actual content of an argument. In therapy: You learn to notice and regulate these physical cues in real time, staying present instead of shutting down or escalating.
4.The Couple's Social Contract What it is: The idea that a couple is its own small society, requiring an explicit agreement between its members. In PACT: Relationships thrive on clarity, not assumption, about how you'll protect, prioritize, and show up for each other. In therapy: You and your partner build real agreements together, rather than relying on unspoken expectations.
The Four Foundations of PACT Couples therapy
1.Neuroscience What it is: The study of how the brain is wired to detect threat and seek safety and connection. In PACT: Understanding which parts of your brain drive conflict versus connection helps explain why arguments escalate the way they do. In therapy: You learn to recognize these patterns as they happen, rather than only after a fight is over.
2.Attachment Theory What it is: The biological and psychological need humans have for close relationships, and the patterns we develop around seeking and maintaining connection. In PACT: Rather than simply labeling partners "anxious" or "avoidant," PACT looks at what's actually happening between partners in the present moment. In therapy: You and your partner learn to recognize when old attachment strategies take over, and practice responding differently.
Why PACT Is Different From Other Couples Therapy Approaches
PACT is particularly distinctive in its emphasis on observing and working with a couple's interaction in real time, including physiological arousal, nonverbal cues, attachment dynamics, and the agreements that organize the relationship. Rather than only discussing a conflict after it happens, PACT works with what's happening between partners as it happens.
Patricia & our team have advanced training in the Gottman Method and Relational Life Therapy, allowing them to draw from multiple couples-therapy frameworks rather than relying on a single model for every couple.
What Happens During PACT Couples Therapy?
You talk about what's happening. Your therapist learns about your relationship, history, current concerns, and goals.
You may demonstrate what's actually happening. PACT is especially interested in your interaction in real time, so your therapist may ask you to show, not just describe, a difficult moment between you.
Your therapist observes closely. Attention is paid to facial expression, posture, tone, timing, proximity, and physiological arousal.
You practice a different response. Rather than only understanding a pattern intellectually, you get to practice relating differently in the moment, with support.
You create agreements that protect the relationship. PACT incorporates the idea of a couple's social contract, the explicit and implicit agreements that help partners build a relationship organized around mutual safety, fairness, and protection.
Frequently Asked Questions
-
Yes. Perinatal mood and anxiety disorders (PMADs) are the most common complication of childbirth, affecting a significant number of new parents. What you're feeling has a name, and it's treatable.
-
No, We work with any parent navigating the perinatal period, including partners experiencing their own anxiety, depression, or identity shifts during this time.
-
Absolutely! many clients start prenatal therapy proactively, to build coping tools and process fears before birth rather than after a crisis.
-
We don't accept insurance directly, but we're happy to provide superbills for clients with PPO plans and out-of-network benefits, which you can submit to your insurance for potential reimbursement. Some of our providers also offer sliding scale spots — reach out to ask about availability.We know that getting to an office with a newborn or while pregnant and exhausted or combining two schedules can be its own barrier to care. That's why we offer secure virtual sessions to clients throughout California and New York
Ready to build a more secure relationship?
Schedule a free 15-minute consultation to see if PACT couples therapy is the right fit for you and your partner.