Depression and relationships
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Depression and Relationships. Nathaniel R. Herr Psych 137C Summer 2004. What is Depression?. Depressed Mood, Loss of Interest Also: Sleep and Eating Problems Concentration Difficulty Memory Problems Feelings of Guilt Suicidal Thoughts Episodic, Long-Term Disorder.

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Depression and Relationships

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Depression and relationships

Depression and Relationships

Nathaniel R. Herr

Psych 137C

Summer 2004


What is depression

What is Depression?

  • Depressed Mood, Loss of Interest

  • Also:

    • Sleep and Eating Problems

    • Concentration Difficulty

    • Memory Problems

    • Feelings of Guilt

    • Suicidal Thoughts

  • Episodic, Long-Term Disorder


Interpersonal impairment

Interpersonal Impairment

  • Poorer social skills

  • Less motivation to interact socially

  • More irritable

  • Reassurance-Seeking (Joiner, 1994)

    • The tendency to excessively ask others for reassurance of worth

  • Depressed people are not the most fun to be around!


Interpersonal environment

Depression

Interpersonal

Problems

Interpersonal Environment

  • “Transactional Nature” of Depression

    • Stress Generation (Hammen)

    • Vicious Cycle

    • Reassurance-Seeking Spreads Depression


And as if things weren t bad enough

And as if things weren’t bad enough…

  • Mate Selection

    • More depressed partners

    • More anxious partners

    • More personality disorder partners

    • More substance abusing partners

    • More abusive partners


Effects on marriage

Effects on Marriage

  • Depressed Wives:

    • Poorer Quality Relationships

    • Poorer Conflict Resolution

    • Lower Marital Satisfaction

  • Cause + Effect?

    • These problems obviously could make someone depressed


What about men

What About Men?

  • Little Research

  • Worse Marital Satisfaction

    • But even worse if wife is depressed instead

  • Wives:

    • Marital Satisfaction  Depression

    • Depression  Marital Satisfaction

  • Husbands:

    • Marital Satisfaction  Depression

    • Depression not related Marital Satisfaction

    • Why?


Summary

Summary

  • Depression causes interpersonal impairment

  • These problems are “transactional” in nature:

    • Depression causes social problems, social problems cause depression

  • Depressed spouses have more marital problems and lower marital satisfaction

  • Research has typically focused on women, but men have problems too.


Couple therapy

Couple Therapy


Different approaches to therapy

Different Approaches to Therapy

  • Traditional Behavioral Couples Therapy

  • Cognitive Therapy

  • Integrative Behavioral Couples Therapy


Traditional behavioral couple therapy tbct

Traditional Behavioral Couple Therapy (TBCT)

  • Assessment of couple’s strengths and weaknesses

  • Specify changes – avoid “not” behaviors

  • Communication Training

    • “I” statements

    • Focus on specific situations

    • Listening skills – paraphrase, reflection

  • Problem Solving Training

    • Define problem, acknowledge each spouse’s role

    • Evaluate pros and cons

    • Negotiation, Agreement, Experimentation


Problems with tcbt

Problems with TCBT

  • Change does not always stay over time

  • Sometimes there is behavior change, but not a change in marital satisfaction

  • People don’t want to change!


Cognitive therapy ct

Cognitive Therapy (CT)

  • Main Assumption:

    • Problems come from “faulty cognition” – thinking about things in the wrong way.

  • Attribute problems to partner (not self)

  • Unrealistic expectations

  • Have problematic assumptions (CL)

  • Selective Attention: Focus on negative


Cognitive therapy cont

Cognitive Therapy (cont.)

  • Goal: Identify and change faulty cognitions

  • Intervention

    • Teach about cognitive errors

    • Person as “scientist”

    • Examine evidence for belief

    • “Experiments” and homework

    • Identify exceptions (avoid all-or-nothing thinking)

    • Use questioning rather than commands


Problems with ct

Problems with CT

  • Favor more “logical” partner

  • Not well-suited for dealing with emotions

  • Can overemphasize thinking instead of doing

  • Focus on specifics can miss the bigger picture

  • Has not been shown to be more effective than TBCT


Integrative behavioral couple therapy ibct christensen

Integrative Behavioral Couple Therapy (IBCT; Christensen)

  • Emphasis on broad themes (instead of specific situations)

  • Emphasis on Acceptance (instead of change)

  • Emphasis on “contingency shaped” behavior

    • TBCT uses “rule-governed” behavior, where rules are imposed to promote change

    • “Contingency shaped” behavior is when change is elicited by introducing new ideas or situations


Acceptance

Acceptance

  • Focus on “receiver” not “doer”

  • Acceptance leads to greater intimacy

    • Reduces defensiveness

    • Leads to acknowledgement of responsibility

  • Acceptance can lead to change

    • Reduces pressure to change…which actually can help make change

    • Easier to change when you feel accepted

    • Easier to accept someone when you see change


Research on ibct

Research on IBCT

  • Currently going on at UCLA (Christensen)

  • Small amount of research that exists suggests that IBCT works better than TBCT

  • Addresses some of the problems with TCBT:

    • Specifically, the emphasis on contingency shaped behavior, not rule based, leads to greater cooperation in treatment and higher marital satisfaction.


Being a couples therapist

Being a Couples Therapist

  • Interacting with two or more people at once

  • Working both individually and together

    • Confidentiality

    • Trust

  • Trying not to focus on an “identified patient”

  • Trying not to take sides

  • Thinking on your feet and being creative


Summary1

Summary

  • TBCT focuses on identifying and changing specific behaviors

  • CBT focuses on identifying and changing faulty cognitions

  • IBCT focuses on broad relationship patterns and acceptance of the other

  • Working with two different people who bring different agendas to therapy is especially difficult for couples therapists


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