DBT for High Conflict Couples

Mary and John have had the same predictable fight week after week for almost five years. They have it down to who says what when. They both could benefit from DBT.

Imagine — Mary and her husband, John, have the same predictable fight week after week. John cheated on Mary five years ago and she can’t let it go.  When John is late getting home from work, which happens frequently, she obsesses he’s having another affair and is going to leave her.  By the time he gets home, she is so worked up she accuses him of cheating and threatens suicide if he leaves.  He dreads walking in the door because he knows what’s coming.  By the time he pulls in the driveway, he’s just as worked up as she is.  According to script, he rages while she cries and begs and throws things. He starts drinking and she goes to the bathroom to cut away the pain with a razor blade.  The next morning, she apologizes and he goes about his business silent and hung over.  She calls him six times over the course of the day to apologize.  He refuses her calls.  In between calls, she beats herself up for what happened.  She can’t let go of the thought that he is going to leave and it will be her fault. 

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Storytelling: Changing the Narrative

Our memories of past events come from “narrative truth,” rather than “historical truth.” We remember the stories we tell ourselves about what happened, not what actually happened.

A couple of blogs ago, I talked about the five options our clients (and we) have when confronted with a problem. We can:

  • Solve the problem in whole or part
  • Change the way we think and feel about it
  • Radically accept it
  • Make ourselves miserable
  • Make the situation worse

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Mindfulness Across Spiritual Traditions

I have started explaining mindfulness and meditation to some clients in the context of their own spiritual tradition, when appropriate. The key words here are “some clients” and “when appropriate.” Careful assessment is needed ….

As therapists, whether we are using DBT, MBSR, ACT, MBCT, MBRE or another mindfulness-based approach, most often we tell clients mindfulness evolved out of Eastern spiritual traditions when we introduce it.  We take care to explain that the benefits of mindfulness are documented with hard science[i] and mindfulness will be presented based on the science stripped of its spiritual roots.

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