View from the Couch

Couples and Conflict 

Most of us would rather stick needles in our eyes than go to couples counseling. This can be true despite devastating conflict eating away at our most precious relationships.Why are we so afraid of the shared couch experience?

Well, maybe we’re afraid that our therapist will side with our partner and find something wrong with us, maybe even ask us to change. Maybe we’re even more afraid that in the light of an outsider’s spotlight, we might realize that there is something wrong with our cherished partner or something so irreparably wrong with our relationship that we may be confronted with a decision we are not ready to make—to leave or to live in Loserville.

We are not entirely wrong to have these fears (after all, we’re not stupid). In couples counseling we probably will be asked to make changes. Changes that will reduce conflict and restore love and trust and fun and all those things we wanted when we got into this relationship in the first place. Change can be difficult, but living in a conflict-ridden relationship is a soul-sapping experience that we don’t deserve and we don’t have to endure.

Most couples come into counseling due to conflict. Sometimes this conflict is caused by something serious like infidelity that erodes the trust that is the foundation of the relationship. But before the cheating, the relationship was already in trouble, most likely aided and abetted by lousy conflict resolution.

So let’s look at some common conflict patterns and how they can cause problems. You’ll probably find your relationship in this list. And here is the good part---there is nothing inherently wrong with any of these patterns, even though they can go dreadfully wrong (more on this later).

Distancer-Pursuer

Susan gets mad because Dan had his friends over and didn’t pick up any of the dishes and complains to him about it. He says, “what’s the big deal, it’s just a few glasses.” She tells him about all the other times he left the dishes out, didn’t pick up his clothes, didn’t do the laundry. Dan tells her not to make a federal case out of it and goes in to the den. She follows him into the den, and now she is yelling, “why don’t you ever help around here. I’m exhausted with everything I have to do and you never listen to me.” He says, “I’m not going to listen to you when you are ranting like this,” and heads to the door. Now Susan really gets escalated and says “you always do this, you leave and leave me with the mess and I just can’t take it anymore. You don’t love me or you wouldn’t do this to me.” She is crying and yelling. He says, “you always back me into a corner, I am out of here.” Dan leaves, and goes to get a beer and texts an “old friend” (you guessed it, she’s female). Susan calls her mother and gripes about Dan. Her mother never liked him to begin with and Susan is starting to see why.

Whoa, and all about a few dishes that would have taken two minutes to pick up. Except, that’s not what it is about. Dan and Susan are playing out a classic Distancer-Pursuer relationship, in a dysfunctional manner. Susan wants to be listened to, and when Dan blows her off, her Pursuer button gets pushed and she takes it up a notch, generalizing a few dirty dishes into a pattern of disregarding her feelings. This triggers Dan’s Distancer button, and he starts shutting her out. Desperate to be heard, Susan escalates more. Desperate to escape, Dan does so. And nothing gets solved.

Dan, who loves Susan, and just wants to be left alone and not criticized, never learns that Susan is not really mad, she is scared that there may be a power imbalance in their relationship. You see Susan grew up in a family where her Dad disregarded and discounted her mother, fooled around, and not surprisingly didn’t pick up the dishes. Susan, who worships Dan, never finds out that Dan can’t listen to her when she yells because his mother was a perfectionist about her house, a screamer who drank too much and beat him and his sister. Dan’s trauma response is triggered without his even recognizing it, and he literally can’t stay in the room with her.

This is a common pattern with couples, nearly as often played out with the male pursuing and the female fleeing (think jealous boyfriend and meek, shut down partner). The underlying causes are different, and a good bit of couples’ therapy involves uncovering and understanding those childhood wounds and family of origin rules. Once we truly understand what is underneath our partner’s offensive-to-us behavior it is far easier to manage our own feelings and reactions and solve rather than escalate conflicts.

Distancer-Distancer

Both partners are easily triggered by conflict and avoidant by nature. It may look calm, but it can be cold like an iceberg, with danger lurking below the surface. Couples drift apart, and start avoiding one another due to perceived slights. Problems are never addressed, mind-reading is rampant, and couples can find themselves going through the motions of a relationship. These are often the people who stay together for their children, and split up after 20 or more years of what looked like a happy marriage to outsiders

Pursuer-Pursuer

If the Distancer-Distancer couple is cold, the Pursuer pair is hot, hot, hot… Do you remember the War of the Roses movie where Michael Douglas and Kathleen Turner made us laugh as they tried to kill each other? In reality, this is often not so funny, with couples who both get easily triggered and often escalate from 0 to 100 in a heartbeat, to fly into combat with each other. These passionate relationships can be volatile, and sometimes dangerous. You are not wrong if you are a Distancer, or a Pursuer. And your partner is not wrong, either. However, if you want to work out problems in your relationship rather than blow them up or bury them, you may have to endure some discomfort as you learn to more deeply understand and accept your partner, and work on changing yourself. If you are a Distancer, you may never be comfortable with loud criticism. But you may be able to negotiate with your partner to adapt your responses in a way that works better for that person you say you love. Wait a minute, doesn’t my partner have to change, too? That would be up to your partner. We can’t change anyone but ourselves. Don’t you hate that? Let’s talk about it.

There’s room for two, on the couch….

Dr. Cindy

Posted by Dr. Cindy Seamans, March 6, 2017

When the New Year is Not so Happy

January can be a tough time. The Holidays are over and perhaps they didn’t live up to your expectations. Or maybe they were a flat-out family train wreck (it happens).

We’re left with depleted bank accounts, expanded waistlines, dreary weather and a long expanse of work days until the next break… Having a case of the midwinter blahs can be normal. But what if it’s more than that? How can you know if you are depressed I mean really depressed, the kind of depression that needs treatment. And what kind of treatment is there, anyway, that can help? After all, it’s probably all just in your head, right? Precisely! And your head is a pretty important part of your body and it deserves treatment, too… Untreated depression can lead to substance abuse, broken relationships, lost jobs, self-harm and sadly, suicide.

Depression is treatable, you can feel better---but let’s not get ahead of ourselves. First, how do you know if you are depressed?

Depression is the common cold of mental illness and it affects lots of us.  The lifetime prevalence of major depression for women is 20-26% and for men is 8-12% (Journal of American Medical Association, 1996).  Postpartum depression (following childbirth) is a contributing factor for women and can be surprisingly intense.  All of us can be susceptible to Seasonal Affective Disorder or SAD, that recurring gift of winter when our mood is as dark as the long winter nights and our tempers as short as the short dim days.

But let’s get back to how you can know you’re depressed…  First of all, you need to have either depressed mood or loss of interest and pleasure(in things you used to find pleasurable) during the same two-week period. The time frame is important here.  Most of us get sad for a random day or three, but if you are depressed continually for two weeks, this is not right.  Then you need another four of the following factors:

Significant weight loss or gain.

Difficulty sleeping or sleeping too much.

Restlessness or lethargy that is observable by others.

Fatigue or loss of energy nearly every day.

Feelings of worthlessness or excessive guilt.

Difficulty thinking or concentrating or indecisiveness.

Recurrent thoughts of death or suicidal thoughts or plans.

These symptoms must cause significant distress and impairment in social or occupational or other functioning, and must not be caused by drugs, alcohol or other medical conditions.(paraphrased from the DSM-5 Diagnostic Criteria from the American Psychiatric Association).

Okay, so now it’s official, you know you are depressed, or getting close to it.  What can you do?  Our best data (remember, I’m a psychologist, I love evidence and research) tell us that a combination of talk therapy and medication is the most effective, fastest road to mood improvement.  Does everyone need anti-depressant medication?  Not necessarily, but it’s certainly worth considering.  And, it’s definitely worth considering counseling to help change your thinking and your behavior so you can feel better.  Soon.  Cognitive Behavioral Therapy has the most evidentiary support for the effective treatment of depression (there’s that psychologist stuff again).  I have many years of experience and success helping clients with CBT, but everyone is not just alike, and that may not be the right treatment for you.   What I am sure about is that you deserve to feel better, and that together we can find a plan that will work for you. You can do it.  I can help.  Come see me and we’ll talk about it ….on the couch….

Dr. Cindy

Posted by Dr. Cindy Seamans, January 5, 2017

Happy Holidays, or Maybe Not So Much?

The beginning of the holiday season marks one of the most stressful periods most of us maneuver through each year. Perhaps yours is the perfect family I read about in those chatty Holiday letters full of beaming children, impressive achievements and fabulous trips. You’re reading this blog, so maybe not so much – and you are not alone! Family expectations, money pressures, overbooked schedules, cranky partners, demanding children... Oh, and those pants you were going to wear to that party are now too tight after those work buffets and mindless snacking on the holiday treats that are everywhere.

This year it can be better. Yes, change is possible and that is truly exciting. Here is the secret to making your life better this Holiday season: Choices. As in, you can choose to do something different. I know, there are traditions, expectations, demands, desires. Are you ready to open your mind, really look honestly into your heart, and figure out what YOU want to do? Here are some choices you can consider (remember, you don’t have to choose them, that’s why we call them choices!)

Getting a stomach ache just thinking about eating two Thanksgiving meals to keep all the in-laws and outlaws happy? Make this the year you flip a coin and start alternating your guest appearances. No one will die. Trust me.

Dreading that office Holiday party that is deadly boring if not downright dangerous? Get a headache or maybe a stomach virus. Send your regrets and then don’t have any! Take a bubble bath, read a trashy novel or watch a basketball game. If you don’t take care of yourself no one else will. (and you can find out what happened Monday. No one will argue with a stomach virus.)

Worrying about buying the perfect gift for a list of relatives you don’t know that well? Or maybe you are really lucky and they are picky and hard to please. This is where the choices get fun! Here’s a couple:

Give a small donation to your favorite charity in everyone's name. (They may not love this, but it would look too petty for them to complain about it.)

Announce that your December gifting opportunity is obviously all about the children, so this year you are only buying gifts for the kids. Then do it.

Of course you could call everyone in advance and suggest drawing for names and only buying one gift. This one probably takes the most courage, but could be the most rewarding—you’re probably not the only one in the family who feels this way.

Already mad because you know your partner won’t choose the gift for you that you really want? Ask for it. Specifically. Expecting your partner to read your mind is really not fair and creates unnecessary resentments. You get extra credit for telling him/her where to find it.

See how easy it is to make choices? Not yet? Call me and we can talk about it on the couch.....

Dr. Cindy

Posted by Dr. Cindy Seamans, December 5, 2016