I Don't... You Don't... It Don't Matter, Depression and Anxiety in Couples and Couple Therapy
By Ronald Mah
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About this ebook
"I Don't... You Don't... It Don't Matter, Depression and Anxiety in Couples and Couple Therapy" Depression and anxiety are at the root of many relationship problems or are intricately and mutually related to several emotional, psychological, and intrapersonal or interpersonal dynamics. Feelings of not mattering combine with messages to the partner that he or she does not matter trigger. The therapist is shown how all therapy is essentially about depression and anxiety that almost inevitable comes up in intimate relationships or marriage. Resolution of needs to matter or not matter to each other determine whether relationship triggered depression and anxiety is transitory or becomes problematic and chronic. Ineffective and inefficient efforts to alter negative circumstances lead not just to depression, but also to anxiety that anticipates harm not just for an individual but for the couple. There are gender and cultural aspects to depression and anxiety that the therapist should incorporate into treatment. Identification of stressors- both proximal and distal and the individual and the couple's habitual responses lower or increase depression and anxiety. Therapy needs to address these issues along with underlying issues in the family-of-origin including attachment styles, communication patterns, and problem-solving models. The therapist is cautioned to avoid becoming infected with client depression and anxiety. Therapeutic frustration can lead to the therapist feeling his or her clinical actions: feedback, interpretations, caring, sensitivity, wisdom, interventions, and suggestions do not matter. Interrupting client-therapist depressed or anxious infection can be the key intervention to break negative partner mutuality..
Ronald Mah
Therapist, educator, author and consultant combine concepts, principles, and philosophy with practical techniques and guidelines for effective and productive results. A Licensed Marriage & Family Therapist (licensed 1994), his experiences include:Psychotherapist: individual, child and teen, couples, and family therapy in private practice in San Leandro, California- specialties include challenging couples, difficult teenagers, Aspergers Syndrome, Attention Deficit Hyperactive Disorder, learning disabilities, cross and multi-cultural issues, foster children, child development, parenting, and personality disorders;Author: twenty-one project/books on couples therapy for a doctoral program, including substantial work on major complications in couples and couples therapy (including depression, anxiety, domestic violence, personality disorders, addiction, and affairs); articles for the Journal of the California Association of Marriage & Family Therapist (CAMFT) on working with teenagers, elder care issues affecting family dynamics, and assessing dangerous clients, online courses for the National Association of Social Workers- California chapter (NASW-CA) on child abuse prevention, legal and ethical vulnerabilities for professionals, and difficult children, “Difficult Behavior in Early Childhood, Positive Discipline for PreK-3 Classrooms and Beyond” (Corwin Press, 2006), “The One-Minute Temper Tantrum Solution” (Corwin Press, 2008), and “Getting Beyond Bullying and Exclusion, PreK-5, Empowering Children in Inclusive Classrooms,” (Corwin Press, 2009); Asian Pacific Islander Parent Education Support (APIPES) curriculum for the City of San Francisco Department of Human Services (1996), 4th-6th Grade Social Science Reader, Asian-American History, Berkeley Unified School District, Berkeley, CA, (1977), and trainer/speaker of 20 dvds on child development and behavior for Fixed Earth Films, and in another time and career three arts and crafts books for children: two with Symbiosis Press (1985 &1987) and one with Price, Sloan, and Stern (1986);Consultant and trainer: for social services programs working with youth and young adults, Asian-American community mental health, Severe Emotional Disturbance (SED) school programs, therapeutic, social support, and vocational programs for at risk youth, welfare to work programs, Head Start organizations, early childhood education programs and conferences, public, private, and parochial schools and organizations,Clinical supervisor: for therapists in Severe Emotional Disturbance (SED) school programs, child and family therapists in a community counseling agency, Veteran Affairs in-patient clinician working with PTSD and dual diagnoses, foster care services manager for a school district, manager/supervisor for the Trevor Project-San Francisco, and therapists in a high school mental health clinic;Educator: credentialed elementary and secondary teacher, Masters of Psychology instructor for Licensed Marriage & Family Therapy (LMFT) and Licensed Professional Clinical Counselor (LPCC) track students, 16 years in early childhood education, including owning and running a child development center for 11 years, elementary & secondary teaching credentials, community college instructor, and trainer/speaker for staff development and conferences for social services organizations including early childhood development, education, social work, and psychotherapy.Other professional roles: member Ethics Committee for six years and at-large member Board of Directors for four years for the California Association of Marriage & Family Therapist (CAMFT), and member Board of Directors of the California Kindergarten Association (CKA) for two three-year terms.Personal: married since 1981 after dating since 1972 to girlfriend/wife/life partner with two wonderful strong adult daughters, and fourth of five American-born children from immigrant parents- the older of the "second set" of children.
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I Don't... You Don't... It Don't Matter, Depression and Anxiety in Couples and Couple Therapy - Ronald Mah
I Don't… You Don't… It Don't Matter
Depression and Anxiety in Couples and Couple Therapy
Published by Ronald Mah at Smashwords
Copyright 2013 Ronald Mah
Ronald Mah's website- www.ronaldmah.com
Smashwords Edition, License Notes
This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you're reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.
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Linked Table of Contents
Abstract
Chapter 1: I DON'T MATTER- YOU DON'T MATTER
Chapter 2: GENDER DIFFERENCES
Chapter 3: CULTURAL PERSPECTIVES
Chapter 4: ALL THERAPY IS ABOUT DEPRESSION AND ANXIETY
Chapter 5: MARRIAGE IS ABOUT DEPRESSION AND ANXIETY!
Chapter 6: STRESSORS THAT CAUSE DEPRESSION/ANXIETY AFFECTING MARITAL DISTRESS
Chapter 7: ANTECEDENTS- DISTAL ELEMENTS
Chapter 8: HABITUAL RESPONSES & ATTRIBUTIONS
Chapter 9: DEPRESSION AND ANXIETY MAKES SENSE- OK IS CRAZY!
Chapter 10: ATTACHMENT
Chapter 11: COMMUNICATION & PROBLEM SOLVING
Chapter 12: THERAPIST DEPRESSION & ANXIETY
Bibliography
Other Books by Ronald Mah
Biographic Information
Abstract:
Depression and anxiety are at the root of many relationship problems or are intricately and mutually related to several emotional, psychological, and intrapersonal or interpersonal dynamics. Feelings of not mattering combine with messages to the partner that he or she does not matter trigger. The therapist is shown how all therapy is essentially about depression and anxiety that almost inevitable comes up in intimate relationships or marriage. Resolution of needs to matter or not matter to each other determine whether relationship triggered depression and anxiety is transitory or becomes problematic and chronic. Ineffective and inefficient efforts to alter negative circumstances lead not just to depression, but also to anxiety that anticipates harm not just for an individual but for the couple. There are gender and cultural aspects to depression and anxiety that the therapist should incorporate into treatment. Identification of stressors- both proximal and distal and the individual and the couple's habitual responses lower or increase depression and anxiety. Therapy needs to address these issues along with underlying issues in the family-of-origin including attachment styles, communication patterns, and problem-solving models. The therapist is cautioned to avoid becoming infected with client depression and anxiety. Therapeutic frustration can lead to the therapist feeling his or her clinical actions: feedback, interpretations, caring, sensitivity, wisdom, interventions, and suggestions do not matter. Interrupting client-therapist depressed or anxious infection can be the key intervention to break negative partner mutuality.
Link to Table of Contents
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**Author’s Note: Other than public figures or people identified in the media, all other persons in this book are either composites of individuals the author has worked with and/or have been given different names and had their personal identifying information altered to protect and respect their confidentiality.
Chapter 1: I DON'T MATTER- YOU DON'T MATTER
The couple therapist can never know what the couple will bring up in session. He or she can never know what was started the fight-of-the-week. Things that seem otherwise to be insignificant will sometimes trigger incredibly intense and scarring battles. Something that should not matter or should not matter that much somehow becomes a matter of life and death. Kyle accused Isabelle of putting too much spice in his food. You know I can't have spicy food. It aggravates my ulcers.
Isabelle retorted, The one time you come home for dinner on time, you bitch about the food being spicy. How about how long I took to cook? With all the chores… the kids… shopping… How many times, you don't even let me know that you won't be coming home for dinner? How do you think I feel?
Make me some decent food and I'll come home for dinner more often,
Kyle said tensely. I spend all day at work… and all I ask is for a little less spice! I might as well grab a bite on the way home. Didn't I ask you? Didn't you hear what my doctor said?
Isabelle wept into her hands, And what about me!? What about what I need?
I don't matter …
and there's nothing I can do about it.
Each person has a fundamental need to feel that he or she matters, including having power and control. Depression may be conceptualized as not mattering to others, within relationships, and the world. Anxiety may be conceptualized as non-specific fear due to vulnerability to harm from not mattering to others, within relationships, and the world. In a healthy couple's relationship while balancing mutual needs, each person experiences subjective and objective power and control over his/her own mind, body, voice, energy, needs, and passion. Partners experiment with mastery and control with each other and seek to get feedback that they matter, have control, and are safe. A partner who has been emotionally and spiritually disempowered because of abuse, neglect, trauma, and/or stress becomes vulnerable to being triggered by activity that threatens a sense of importance, value, and power and control. It is often in the couple's relationship that the sense of mattering or being safe is most tested. Any experience of dismissal or empowerment, whether real or implied can threaten the individual. The individual can become depressed and/or anxious. On the other hand, when a person validates his/her partner- in other words, prompts joy, exhilaration, hope, or importance, a sense of mattering and having power and control is fostered. Affective interactions and power dynamics affect each partner and subsequently, affect the relationship. Both the consequences and attempts to change the balance may create other reactions.
Kyle and Isabelle both responded to a sense of not mattering or not being in control by giving messages to the other that You don't matter.
Mattering may be existential in terms of being valued or it may be in functional terms of power and control. The… view popularized widely by Jay Haley and also by feminists, is that power is central to all human relationships, and while patterns of mutual influence may occur, mutuality of influence does not necessarily entail equality of influence. Inevitably, hierarchical patterns of organization permeate human system
(Byrne and Carr, 2000, page 425). The therapist needs to be aware that when a partner feels less importance or less powerful, he or she may develop depression that changes the hierarchical arrangement within the relationship. …non-depressed spouses try to keep their depressed spouses' exercise of control a constant amount (vertical gap) below their own. According to this theory, if one partner's mood is low or if one partner requires a large vertical gap, he or she may need to maintain their spouse's mood within the depressive range, and any efforts to raise it (for instance, in therapy) will be countered (Byrne and Carr, 2000, page 408-09). Issues over power and control may arise in different ways.
Cromwell and Olson (1975), in a thoughtful analysis, argue that power may be conceptualized as a construct incorporating three analytically distinct but interrelated domains: power bases, processes and outcomes. Power bases are economic and personal assets, including control of optional spending, commitment, sex-role attitudes, intimacy desires, and forms of aggression. These form the basis for one partner's control over the other. Power processes are what one uses to gain control over parts of the relationship. These include persuasion, problem solving, or demandingness. Power outcomes are about who has the ultimate say when addressing problems or making decisions (Byrne and Carr, 2000, page 409). Lack of adequate power bases, processes, and outcomes in a relationship may trigger helplessness or hopelessness- in other words, depression. Inconsistent fluctuations in power bases, processes, and outcomes would foster uncertainty about interactional outcomes, partner response, and behavioral consequences- in other words, anxiety. The couple therapist should take note of couple's interactions that express personal messages of
not mattering" about oneself or the partner. These may be indicative of a partner's depression and anxiety and a couple dealing with such depression and anxiety.
Link to Table of Contents
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Chapter 2: GENDER DIFFERENCES
Women's power bases may reflect social and cultural gender inequities. They may be financially vulnerable and subsequently or concurrently psychologically weaker. Power outcomes for women in household and childcare tasks favored male partners, in particular those who were in non-depressed couples. Power processes were also less constructive and more problematic in such couples compared with non-depressed couples (Byrne and Carr, 2000, page 422). With respect to power bases, the lack of economic power is associated with depression for women. Isabelle was a stay-at-home wife/mother, while Kyle worked. Overtly and implicitly, Kyle asserted his right as breadwinner and man-of-the-house. This is consistent with other research connecting economic disadvantages within marriage to depression. Men and women who rely on passive-aggressive behaviors are also distinctly associated with depression. Isabelle's over spicing could possibly have been a passive-aggressive response to Kyle greater power in the relationship. In terms of power processes, depression was related when women who perceive frequent demands from their husbands where the husbands would subsequently withdraw. How often did Kyle really need to work late or was working late a way to avoid Isabelle's demands? Relative to power outcomes, depression is more common when women perceived partner under or non-involvement in household and childcare tasks, and when both partners were dissatisfied in this sharing or non-sharing or these responsibilities. (Byrne and Carr, 2000, page 424). "The findings on passive aggression and husband-demand-wife-withdraw