Friday, April 16, 2010

REVIEW: The High Conflict Couple

The High Conflict Couple: A Dialectical Behavior Therapy Guide to Finding Peace, Intimacy, and Validation
Alan E. Fruzetti, Ph.D.

I know that the title of this book can be a bit overwhelming initially. After all, what couple wants to think of themselves as "high conflict?" And what is "dialectical behavior therapy?"

Let me start with the second question first. Dialectical behavior therapy is an empirically validated (supported by research) treatment model to help people manage overwhelming emotions. It was originally developed by a psychologist named Marsha Linehan, to help people who experience major mental illness, such as borderline personality disorder or bipolar disorder. However, many people without a major mental illness experience overwhelming emotions. I frequently hear clients say that, "when I get mad, hurt, scared, etc., I just react." This is especially true for couples who are stuck in a pattern of unhealthy communication or conflict.

Dialectical behavior therapy teaches four key skills to help manage overwhelming emotions. The first skill is "distress tolerance." Distress tolerance helps couples focus on the fact that there will be painful and upsetting moments, but that they can increase their resilience, or ability to cope with upset. The second skill is "mindfulness." By increasing a couple's ability to focus on what is happening in the present moment, mindfulness can be a useful tool for helping clients change unhealthy habits such as focusing on the past or allowing fear of the future to overwhelm them. The third key skill of dialectical behavior therapy is "emotion regulation." Emotion regulation is focused on helping couples label and process intense emotions in healthy and appropriate ways. Finally, dialectical behavior therapy teaches "interpersonal effectiveness." Interpersonal effectiveness means that you learn to set boundaries, express feelings and needs, and negotiate conflict--in a respectful, relationship-oriented framework. Obviously, interpersonal effectiveness is a key component for healthy couples.

Now on to the that first question that many couples have--their initial reaction to being described as "high conflict." This is a book that I use with many of my couples. When a couple says to me, "But we don't yell (argue, fight, etc)," I encourage them to think of whether or not they experience recurring conflicts, persistent feelings of being unheard, or on-going hurt feelings. If any of these things are true, this is a useful book.

I believe the content in the book is thoughtful and well organized. Each chapter contains exercises for reflecting on our habitual thoughts and patterns of interactions. Couples are challenged to think beyond their status quo and work to build a more connected, healthy relationship--precisely the goals I have when I work with couples in therapy.

Anyone who connected with my "Power of AND" post is likely to find value in "The High Conflict Couple" because the premise of AND is at the heart of dialectical thinking.

Many of my couples have also expressed appreciation that the book is relatively short. That means that it is easy enough for even busy couples to fit in a chapter a week.

I look forward to hearing what you think!