Dialectical behavior therapy (DBT) is a third-wave evidence-based treatment that has been proven to be effective for individuals with borderline personality disorder and a range of mental health difficulties with underlying emotion dysregulation. DBT has recently been adapted to improve evidence-based behaviorist approaches to couples therapy, primarily by Dr. Alan Fruzzetti, professor of psychology and director of the DBT research program at the University of Nevada, Reno. This blog post introduces some of the techniques that are used in DBT couples therapy to decrease conflict and improve satisfaction in interpersonal relationships.
The primary transaction that takes place between partners during active conflicts has two components: inaccurate expression and invalidating responses. When one partner becomes emotionally dysregulated, that partner may struggle to accurately describe their experience and convey that experience to the other partner. When an experience is conveyed in a way that is not accurate, then the response from the other partner is often invalidating. For example, Ryan feels disappointed with Susan for arriving to dinner an hour late, but masks his disappointment by conveying anger to Susan exclaiming, “Where were you? Do you even care about me?” Susan, naturally, having received an inaccurate emotional expression, responds with an invalidating response, “What are you talking about? Stop the accusations!” Thus, inaccurate emotional expression translates to invalidating responses, and the invalidating responses will often prompt further inaccurate expression. DBT couples therapists help couples to stop, in the moment, and practice accurate expression of emotions and realistic forms of validation that deescalate conflictual interaction.
When working on accurate expressions, it is important to distinguish between primary and secondary emotions. Primary emotions are the natural emotions that arise out of events that directly fit the facts of the event. For example, feeling immediate sadness when we lose a pet, or feeling anger when someone tries to slap us. However, secondary emotions are layered emotions that arise out of other interpretations or judgements of events. For example, feeling angry when we lose a pet because cancer should no
t happen, or feeling sadness when someone tries to slap us because we are sad that the world is violent. Secondary emotional reactions often lead to inaccurate expression and behavior that escalates conflict and leads to confusion in interpersonal relationships. The goal is to identify the primary emotion associated with the event and accurately express that emotional experience to prevent excessive conflict.
In DBT couples therapy, couples will also walk through a series of internal reactions and external events that led up to a conflictual interaction to better understand where potential solutions can be applied. This detailed process is called chain analysis, and in the context of couples therapy, a DBT couples therapist may guide partners through a double chain to provide a better understanding of the specific series of actions and internal reactions that exacerbate conflict within partners’ unique relationship. In addition, another central technique of DBT couples therapy is relationship mindfulness. There are several components of relationship mindfulness, though one component that is particularly important to decrease excessive conflict is to practice mindfully recognizing that the person one is interacting with is the “loved partner.” This skill involves bringing a momentary awareness to the fact that the person who one currently feels negative emotions toward is the person that is loved in a long-term relationship. Practicing this momentary awareness is crucial for preventing excessive conflict.
Some individuals may question whether learning particular skills in couples therapy provides a long-term solution to excessive conflict. Some individuals may propose other formats, like tackling one topic at a time—finances, sex, children. However, the evidence for effective couples therapy points toward skills acquisition and direct coaching by a professional who has the interpersonal skills and knowledge to resolve the emotion dysregulation and the conflictual dynamic. Couples often have the ability to problem-solve on their own. There are, however, specific psychological dynamics that contribute to emotion dysregulation and excessive conflict that require expertise in the dysregulated conflictual state. Committing to this evidence-based process not only leads to increased satisfaction in the primary romantic partnership, but also can generate relationship satisfaction across a wide-range of complex relationship dynamics that most humans inevitably face across the lifespan.
To learn more about DBT couples therapy, check out Dr. Alan Fruzzetti’s book, The High-Conflict Couple: A Dialectical Behavior Therapy Guide to Finding Peace, Intimacy, and Validation. Click here to schedule an initial appointment with one of our DBT therapists.
About the Author
Samuel Eshleman Latimer (he/his), Psy.D., is a psychologist that specializes in dialectical behavior therapy and effective conflict management. Samuel also works to help people find relief from anxiety, trauma, and relationship distress. Samuel believes that people do not need to choose between learning effective techniques that are based on science and developing warm, genuine relationships, as both of these styles complement each other. Click Here to learn more about Samuel’s experience and therapeutic style.