Many couples manage to survive depression with the help of marital therapy, even though most relationship therapies aren’t designed to deal with the added problem of a mood disorder. I’ve been doing a little research and have found that most therapy and counseling for couples doesn’t have a good track record.
In fact, research links the use of traditional couples therapies more often to divorce than to preservation of marriages. When you add in depression, the odds of success seem even more remote. Fortunately, the track record for couples therapy is improving, but not because it’s better designed to deal with depression specifically.
New Approaches to Couples Therapy
Apparently for the first time, new therapies have been developed based on research. That may not sound like news, but it seems that many of the older approaches were, to quote one therapist, simply made up. There was never any evidence to support them.
According to John Gottman, one of the leading researchers in this field and author of The Seven Principles for Making Marriage Work, most of the methods came from individual psychotherapy. They may have worked well in that setting but often didn’t transfer well to the interactions of two people.
Newer approaches have come out of long-term research on the actual behavior of hundreds of couples. They work better because they focus on well-established patterns that couples fall into.
I want to highlight a few of Gottman’s findings because they include some of the ideas that have made it possible for my wife and me to stay together in spite of the impact of depression.
Why Relationships Survive – and Fail
Whether depression has interrupted a relationship of not, there are certain problems and tasks that all couples have to deal with. They make dozens of choices each day about how to relate to each other in small ways, and they often have to deal with serious conflict. However, it’s not the crises that undermine partners.
Gottman’s research shows that relationships don’t fail because of affairs, personality clashes, lack of communication, lack of sex, shouting matches, or the other causes cited by most “experts.” Stable, healthy relationships can and do survive all these problems.
It’s the underlying tension and negativity in a relationship that leads to crisis, not the other way around. Gottman’s research brings out sharp distinctions between the types of behavior found in healthy relationships and the dysfunctional patterns troubled partners follow. Here are a few of his many examples.
Matching Styles of Handling Conflict
All couples fight. Sometimes they quarrel over immediate issues that can be resolved, but most of the time they are fighting about perpetual problems that have no solution. Those are usually rooted in deep-seated personality clashes.
The difference is that couples in good relationships have come to accept these differences while those in troubled relationships have not.
Partners who are not doing well interpret the differences as stubborn and hostile behavior. It feels like your partner will never understand you, will always ignore or frustrate your needs – unless they can become the type of person you want them to be. That’s also an accurate way to describe how a depressed partner thinks.
Couples need to be able to discuss their feelings in a constructive way rather than freeze in fixed beliefs about each other. They can maintain a positive, even good-humored dialogue that lasts through the lifetime of the relationship.
Turning toward each other on an emotional level rather than away is basic to a healthy relationship. Depression highlights what Gottman calls the Four Horseman of the Apocalypse in blocking emotional connection. Defensiveness, contempt, criticism and stonewalling are the worst behaviors that escalate from disagreement into angry fighting.
This goes beyond turning away from each other. It’s turning against each other. Staying together over the long haul depends on showing concern, warmth, responsiveness and affection. If one turns away or ignores these affectionate gestures, there’s little basis for sustaining connection.
If the gestures of concern and affection seem to provoke irritability, then you’re likely heading into escalation of conflict. All the negatives of the interaction become emotionally more violent. The best intentioned words and actions are interpreted as attacks or demands. The pattern is all too familiar to me. I often did exactly that in the midst of depression.
Even couples with well-matched styles of handling conflict mess things up, hurt each other and feel terrible. The point is that they have learned how to repair the damage. They can see that the argument was about a specific problem, not a universal clash, and they can talk through the feelings each one has had.
This is exactly what is so hard when depression hits. Each incident is universalized. It feels like the end of the relationship. Either it’s all the partner’s fault or all yours. There is no in-between. The inability to resolve the problems adds to the pain that partners feel.
Gottman believes that the best way a therapist can help a couple is by guiding them through all the painful feelings of their disagreements. They need to process the feelings fully, learn to live with differences and find positive ways of working through them. They won’t get anywhere by trying only to be affectionate with each other or to avoid conflict or to divert angry feelings or to be positive and upbeat all the time – as many therapists counsel.
He emphasizes that a relationship needs to have a lot more positive than negative experiences to survive. But the way to create more positive interactions is by probing the negative ones.
Has any form of couples therapy worked for you?