What's been really helpful for Karma and I is a conversation like this-
"I am feeling this____. I think it is because of _______."
"Okay I am hearing you say you feel (what, in his words he thinks I am saying) and you think it is b/c of (again his interpretation of what I said.) Is that correct?"
"Okay, what can I do to help. What do you need from me to not feel that way/feel better/heal."
It's been hugely helpful. We learned that we spoke totaly different languages. And had completely different definitions of the same word. Doing this made all the difference for us.
The thing is though, Karma is willing to work, to hear me, to help me and I him.
And I totaly agree with you Sinew, when you are only discussing the pain, it is very hard for the spouse to see or hear anything else. Karma and I had to restrict ourselves to certain periods of time. We only discuss the pain for a certain amount of time. Then that's it. For awhile it was even, he can only discuss her for a certain period of time and then not again the rest of the night.
Then we focussed on us.
Eventualy we let go of the time frames, because the wounds were no longer so raw that it was all we talked about it. It was easier to handle bringing things up as we experienced them, b/c we weren't always having to discuss something painful or how horribly he hurt me.
I realised I wasn't recognizing him for the good things. So I made it a point to say Thank you. I also made it a point to say "When you did what I needed and followed my boundries today, that meant alot and rebuilt some trust because now I know I can count on you for that."
I've found that 1000 positive comments can be lost by one negative. I know the negative needs to happen and we have to discuss the hard stuff, so I make sure I am recognizing all the good stuff as well.
Once all of that fell into place, not only was he more patient, but I healed faster and we grew closer.