All posts by Rune Moelbak

I am Rune Moelbak, Ph.D.: A clinical psychologist in Houston, Texas. I write articles on therapy, psychology, and cultural-philosophical critique, and publish my ideas in national and international journals. I am the owner of Better Therapy: A therapy practice for people who are looking for a more in-depth therapy experience.
Broken heart symbolizing divorce

4 Signs that Your Marriage is Headed for Divorce

Couples therapist John Gottman has identified 4 behaviors that are so destructive to relationships that they will almost certainly lead a married couple to divorce.

Due to their ominous nature, he calls them the “4 horsemen of the apocalypse” and because of their destructive nature, they must be stopped at all cost.

Although we almost inevitable end up engaging in these behaviors, it is important to be vigilant about their presence and make conscious efforts to reduce or minimize their impact on your marriage.

Want to know what the four horsemen are? Let’s go through them one at a time:

Criticism:

Couples who divorce often have an unfavorable ratio between complaints and appreciations. John Gottman has argued that about 2/3 issues that married couples fight about have to do with personality differences that are ultimately unresolvable. In strong marriages, couples find ways to develop a greater appreciation and understanding of these differences. They realize that we don’t marry a partner simply to be with a carbon copy of ourselves. In married couples who end up divorcing, however, differences instead turn into annoyances, and annoyances into fights. Instead of asking for constructive changes from one’s partner, or taking the time to understand each partner’s perspective, couples headed for divorce instead engage in a barrage of complaints. In many marriages that are close to the point of divorce, partners often feel that they are always being criticized or are never doing things right. After a while such a marriage becomes tiresome, and each partner begins to retreat in order to self-protect.

Defensiveness:

When you feel attacked and criticized, you defend. Defensiveness is one of the hallmarks of a flailing marriage. Instead of having conversations and being curious about each other, couples who are on their way to a divorce, tend to simply stick to their guns and play the blame game. Instead of listening for their partner’s feeling and showing that they care, they instead focus on telling their partner why their complaint is unreasonable or wrong. Over time, each partner becomes an island onto themselves, focused simply on proving their own point at the expense of their partner. In this kind of atmosphere, each partner ends up feeling not understood and this of course leads to emotional disconnection. When you are at war, you retreat behind a wall and stop making yourself vulnerable and receptive to your partner. With so much effort dedicated to defending, love dwindles, and both partners often end up feeling deprived and unhappy.

Contempt:

Being in an intimate relationship with a partner is not only a source of joy and love. We often also experience intense anger and even hatred. When our partner disappoints us, when we feel afraid of losing them, or when we don’t feel unconditionally cared for, intense anger is often evoked in us. Although the adult part of us realizes that love is never unconditional, the child within often has a fantasy that it is. When our inner child feels deprived, strong feelings can be evoked that can lead us call our partner names and make comments that undercut our partners’ self-esteem. However, it pays to think twice before saying such things. John Gottman found that couples who end up divorcing, tend to have a high rate of contempt and hostility toward each other. Whereas strong marriages are slanted toward interactions that serve to build each other up, couples who end up divorcing oftentimes end up in negative cycles of cutting each other down.

Stonewalling:

Although some couples think simply ignoring their spouse is a pathway toward peace, fact is, the absence of a response, can be like depriving your partner of oxygen. Researchers on human attachment have found a lack of response a much greater sign of danger than an angry response. For this reason, many couples actually pick fights or provoke their partner into feeling angry or jealous. At least, with this response, they know their partner “sees” them and that they more than likely care. When our partner simply ignores us, it is easy to feel that we don’t even exist. At the level of our “animal” instinct or mammalian brain this often gets interpreted as a danger signal that we are without support and that nobody cares about our existence. Since at our core we are social beings, such absence of love is a threat to our basic survival needs and can send us into panic. In certain partners who had parents who often were absent, any resemblance of this deprivation will evoke fear and anger at their partner for inducing this fear. John Gottman also found that couples who stop acknowledging their partners existence and start to live parallel lives are at the greatest risk for divorce. It is often much easier to restore connection in couples who fight a lot, than it is to restore it, in couples who have simply shut down their emotional response to each other. So the next time you give your spouse the cold shoulder or ignore their bids for connection, know that you are causing harm to your marriage, and try to find at least some way to engage.

Dr. Rune MoelbakAbout Me: I am Rune Moelbak, Ph.D., a couples therapist in Houston, Texas. I help couples develop better communication skills and restore emotional connection.                     To read more, visit my website: www.bettertherapy.com

therapy as a machine

What’s Wrong with Empirically Supported Treatments?

Psychologists in the field of psychotherapy like to engage in debates about scientific proof. Oftentimes this leads to arguments about which therapy has achieved the status of an “empirically supported treatment”…

An empirically supported treatment is a therapy that has been proven to work for a particular mental health condition. If you have received a diagnosis of social anxiety disorder, for example, an empirically supported treatment would be one that has been found to reduce social anxiety with a reliability higher than that of no treatment or an alternative treatment.

So what’s wrong with that?

To answer that question, we have to dig a little deeper…

The Mechanics of Empirically Supported Treatments:

The mindset that underlies the movement toward empirically supported treatments and the scientific quest for proof is a mechanistic one.

Therapy is perceived as a set of procedures the therapist “administers” to the client in order to achieve some predictable result.

For this to work, the therapist must agree to deliver interventions according to certain fixed procedures that show “fidelity” to the specific treatment that is being tested. The therapist, in other words, must simply become the tool or vessel for the treatment.

The client on the other hand must be reduced to the passive recipient of the “treatment”. It is not even clear that their subjective experience really matters. What matters is the “end result” or effect that the treatment produces. The client is, in other words, just a set of mental and physiological reactions that can be manipulated or caused in some predictable way.

In short, the philosophical underpinnings of the movement towards empirically supported treatments are mechanistic: The client becomes an object in the causal chain of action and reaction that makes up the physical world, and the therapist becomes the engineer who figures out how to induce change in the object.

Empirical proof in this model is found through observing or measuring mechanical changes in the client who after treatment may or may not feel anxious anymore, may or may not report feeling depressed, or may or may not function better in their relationship.

This kind of proof separates cause (treatment) and effect (results) and looks to some external reality for validation that the treatment has had a positive effect.

Why Therapy is not a Mechanical Process of Change:

In reality therapy is an interpersonal process where the therapist learns from the client, just as much as the client learns from the therapist.

The therapist will often entertain multiple hypotheses about the dynamics that could explain the client’s difficulties, but these can be overturned, altered, or refined based on what the client shares and how the client reacts to certain interventions.

The assumption that the therapist unilaterally administers treatment as some engineer aiming for a predictable result, is therefore flawed. Therapy is about learning, not about producing.

The sign of a good therapist is not the ability to be true to a certain therapy modality, but his or her ability to deviate and change course in response to what they learn from the client and jointly discover through the therapy itself.

This also means that the therapist cannot be guided by specific goals or predefined interventions, because what a client wants or needs, and what would be effective, changes depending on the moment and the context of each interpersonal encounter and each specific interaction.

Oftentimes what is therapeutic about therapy is precisely that it overturns previous knowledge and makes new possibilities and hypotheses appear.

A problem or disorder is thus not some “static” thing like a tumor or a bad tooth, but a temporary stopping point on a journey toward a much more complex understanding of various life issues that inevitably end up becoming the real “object” of the therapy.

Evidence of Change in Psychotherapy:

One of the biggest compliments I have gotten from a client was someone who told me, “the longer I keep coming here, the more uncertain I feel about what my problem really is”.

This client had initially defined their problem as a specific anxiety disorder, but was coming to the realization that anxiety is really shorthand for a host of unique and highly personal life experiences. It is not a “disorder” that calls for the administration of a specific empirically supported treatment, but a very personal sign of other life issues or problems which the person has yet to confront.

Good therapy helps clients dislodge themselves from preconceived notions of their problems and helps them discover needs and desires they were not aware of from the outset.

This also means that the empirical proof we are after is not some preconceived end goal to be measured only at the conclusion of the therapy.

When therapy goes well, goals and priorities change, problems get overturned, and new issues become salient. This dynamic process of change has to be allowed to unfold according to its own rhythm and logic, and should not be hijacked by a preconceived agenda or a heavy-handed attempt to steer the therapy in a predetermined direction.

The change in this kind of therapy is not external to the therapy, to be validated only by measurements or observations after the fact. Instead it happens as an immediate experience of something resonating in the here and now that changes the client’s view of themselves in a very real and irrefutable way.

This kind of therapy is not about fitting a client into a machine-like production of change, but about facilitating a personal journey where the benefits lie in the discoveries made on the journey itself.

Dr. Rune Moelbak

About me: I am Rune Moelbak, Ph.D., a clinical psychologist in Houston, Texas. I treat people, not problems. To read about my views on therapy, visit my “about me” page, where you can also schedule a therapy appointment.

 

Two Sea Stars

Approaches to Couples Counseling: The Gottman Method

Gottman Method Couples Counseling is one of the most popular and contemporary approaches to couples counseling used by couples therapists today. What makes it so unique in the therapeutic landscape is that it is entirely based on research findings from couples researcher John Gottman’s own studies of married couples.

A Research-Based Approach to Couples Counseling:

John Gottman is a psychologist and researcher who has spent more than 40 years researching couples. Based on his research, he claims to be able to predict which married couples will divorce and which will stay married with 90 % accuracy.

One of the innovations of Gottman’s approach to research was that he observed how couples interacted in a live-in environment just like in the show Big Brother. Through the multiple cameras installed, he was able to see how couples interacted naturally. By studying hundreds of couples this way, he was able to catalogue the behaviors in people who stay married, as well as identify behaviors in those who get divorced.

Based on his research Gottman has constructed a theory of all the behaviors successful couples engage in, which today has become known as “The Sound Relationship House”

The Sound Relationship House:

Sound Relationship House

The Sound Relationship House contains all the elements found to predict relationship success in what is now called the Gottman Method of Couples Counseling.

First we have the pillars of the relationship: Trust and Commitment. These are fundamental to creating the boundaries for there to even be a relationship. They involve being faithful to each other and developing the trust needed to be emotionally vulnerable. According to Gottman, without these pillars in place, you cannot build a sound relationship.

Once the boundaries of the relationship have been established, couples can begin to focus on creating a house in which they want to live.

The foundation of a good relationship is what Gottman Method Couples Counselors refer to as “the friendship system”. The friendship system contains all the elements that make a marriage worthwhile.

In what Gottman calls “Build Love Maps”, the goal is for couples to develop a clear and accurate knowledge of what makes each other tick. You have to allocate “room” in you brain for the other person and to truly know who they are. You have to have a “map” of your partner’s world, otherwise, who are you really in a relationship with, but yourself?

In the Gottman Method of Couples Counseling, couples are also advised to build each other up through creating a culture of sharing their fondness and admiration for each other.

An interesting novelty of Gottman’s research is the idea of “turning towards”, which denotes all the little micro interactions we engage in where we drop what we are doing to respond to something our partner is interested in. They are little moments of connection that seem minor and insignificant, but start to wane when couples grow distant or begin to not like each other much.

Finally, Gottman advocates that partners find ways to laugh at disagreements, give their partners the benefit of the doubt, and otherwise a adopt a positive and lighthearted perspective.

Together these four elements create a strong friendship filled with love, affection, and intimacy.

Only when couples have a strong friendship as their base is there enough love in the “love tank” to make them endure the more difficult times and the many disagreements in values and preferences that are bound to happen over time.

The upper elements of the sound relationship house include conflict management skills, as well as creating shared meaning in the relationship. Conflict management is about learning to communicate with your partner in ways that do not make them defensive, and yet makes you feel heard. Creating shared meaning, refers to creating dialogue around each partner’s dreams and growth ambitions, and having conversations about where the relationship is headed.

How Can Gottman Method Couples Counseling Help Me?

The Gottman Method of Couples Counseling is about teaching couples the skills needed to build their own sound relationship house. The assumption is that couples can learn to emulate ways of interacting and doing things that have been observed in couples that end up staying together.

The Gottman Method is a skills-based approach to creating a strong relationship. By doing more of the right things, and doing less of the relationship-damaging things, you can make your relationship grow in the direction of greater intimacy and satisfaction.

A novelty in the Gottman Method of Couples Counseling is that the therapist acts as a coach or facilitator who helps couples interact with each other by using new rules and guidelines. The goal is for couples to become independent of the therapist and for the therapist to transfer his or her own skills to the couple.

Does the Gottman Method of Couples Counseling Work?

Learning some of the skills of successful couples communication and friendship building can be immensely useful to couples who are often turning to a couples therapist because they just don’t know what to do.

Making a relationship work definitely involves skill, and having some knowledge about what to do, can be very helpful.

One of the limitations of the approach is that it can seem very technical.

In my opinion, couples need more than skills to succeed in their relationships. They also need a deeper understanding of their own needs and desires, and an emotional experience of greater closeness with their partner.

There are simply times when the therapist has to stop being a coach who teaches skills, and has to become the facilitator of greater access to buried emotions and fears in each partner.

In my own couples therapy practice I therefore believe in combining multiple approaches to couples counseling. Although I have training in the Gottman Method and frequently teach my clients new skills, I also have a sound understanding of other more emotion-focused approaches.

Ultimately I believe couples need an emotional experience of change rather than simply a set of techniques.

If you would like to learn some of the techniques utilized by couples therapists, sign up for my free couples guide (click on image):

Couples Guide

Dr. Rune Moelbak

About Me: I am a psychologist and couples therapist in Houston Texas. I have received training in the Gottman Method as well as other couples therapy approaches. To schedule an appointment visit my website: www.bettertherapy.com

psychodynamic conflict

What is Psychodynamic Therapy?

For consumers contemplating seeing a therapist, there are many types of therapy to choose from. One of the most widely practiced forms of therapy, is psychodynamic therapy. But what does psychodynamic therapy really mean? 

What is Psychodynamic Therapy?

Psychodynamic therapy starts from the assumption that people are caught in multiple struggles between opposing demands, impulses, fears, and wishes.

A simple and humorous example of this can be found in the following cartoon, which illustrates the vicissitudes of the human psyche:

Mr. Lovenstein: Adult

Mr. Lovenstein: Adult

The person here is damned if he does – and damned if he doesn’t: A typical dilemma, in which we humans find ourselves…

  • He likes the freedom that comes with being an adult, and abhors the alternative, which would mean being a dependent child without autonomy and choice.
  • However with the pleasant realization that he is an adult, comes the unpleasant realization that freedom comes with responsibility. He is now parenting himself and has to set boundaries on his own desires. The price he pays if he transgresses is: guilt.
  • And yet, he fights back against his internal doubt and asserts his free will to do as he pleases…
  • But when he now chooses to eat his ice cream, he can no longer enjoy it without an intense feeling of shame for having done something wrong.

A Lesson in Psychodynamics:

This simple storyline, humorous as it may be, conveys very well what psychodynamic therapy is really about.

According to a psychodynamic viewpoint, we are often in internal battles with ourselves, having feelings, thoughts, and wishes that pull us in opposite directions all at once.

The result of being such a house divided against ourselves is a sense of anxiety and inner unrest, which only human beings can feel. Since this anxiety is such an aversive feeling to us, we will subsequently go to great extent to avoid it or to find some kind of solution that will silence the conflict that produces it.

To solve our conflicts we will defend against one of the feelings so as to create psychological balance where there previously was none. The way we do this is by deploying psychological defenses that distort the facts of reality for the sake of keeping our inner peace.

Defenses against Internal Conflicts:

Our ice cream lover could attempt to defend against his anxiety in a number of different ways, each of which would reduce the conflict in some way:

  • He could subject himself to his own rigorous parental authority and create rules for how virtuous he has to be to truly earn his ice cream: “I will allow myself an ice cream only on my birthday, and only if I have achieved my goals at work”
  • He could take on the identity of a “rebel” and push away all respect for authority in an attempt to minimize his own “guilty boy” syndrome: “I am not going to follow any rules because authorities don’t know what they are talking about”
  • He could rationalize his sinful enjoyment, by looking only at the evidence against the validity of current research: “Health fanatics always change their mind about what’s healthy and what’s not. They will probably discover that ice cream is healthy in just a few years.”
  • He could also punish himself after enjoying his ice cream, so as to atone for his sin: “I am going to not eat for a week, in order to make up for my weight gain”

These are but some examples of how the human psyche works to help us resolve our internal conflicts.

The Price We Pay for our Defenses:

The bad thing about defense mechanisms is that they have to twist reality in order to make certain feelings, wishes, or thoughts go away. Hence, the more internal conflicts we experience, the more out-of-sync with reality we end up becoming. Gradually we come to live in a reality where certain feelings, wishes, or thoughts get dimmed, shunned, distorted, or repressed. We substitute a fictional reality for the real world in order to preserve our psychological safety.

Another bad thing about defense mechanisms is that if they are challenged in any way, the anxiety is looming right beneath them. This means that we often don’t really have a choice to act any differently than we do.  Hence, we are forced to punish ourselves after eating an ice cream, because if we don’t, our anxiety, our guilt, or our shame will return. We are thus not really in control of our life, but are controlled by our desire to escape from unpleasant feelings which threaten to besiege us.

Our Conflicts Are Often Unconscious:

Most people who come to therapy don’t enter the consulting room with the understanding that they have unresolved internal conflicts. Nor do they know that the symptoms they are experiencing might be the result of defense mechanisms that serve to keep anxiety at bay. Instead they simply feel depressed, anxious, unable to enjoy certain things in life, or besieged by feelings of guilt, shame, or inhibitions.

The goal of psychodynamic therapy is to help people understand the dynamics underlying their most troublesome symptoms so they can begin to make sense of why they feel compelled to starve themselves for a week, why they can’t enjoy having sex with their partner, or why they have become depressed in their marriage.

Often at the first therapy session, symptoms such as these do not make sense, and seem entirely arbitrary.

This is good news for the medical profession, which is quick to jump on this to suggest that the cause is purely biological or brain-based, a conclusion which can seem quite legitimate to the person who suffers without reason.

It is also good news for cognitive-behavior therapists  who can readily get buy-in for the idea that symptoms have no deeper meaning or logic, but should be treated as if they themselves were the problem.

Yet, when clients are helped to become curious about their life and begin the work of talking freely and openly about the full range of their experiences, more clues begin to appear that will eventually allow both client and therapist to discover an underlying logic of the distressing symptom.

An Example of Psychodynamics at Work:

A depressed immigrant from India initially entered psychodynamic therapy because his wife was not happy with him and was thinking about divorce. As his therapy progressed, it became clear that the client had defied his parents’ wish that he enter into an arranged marriage. Although the client initially experienced his choice for a love marriage as a victory for his own autonomy, it was as if another part of him continued to feel guilty about his choice and unconsciously acted in ways that sabotaged his love marriage.

From a psychodynamic perspective, the client was not simply being irrational or self-destructive. Instead he was trying to resolve an unconscious conflict between retaining autonomy and not upsetting his parents.

The solution he had found helped him equalize his guilt feelings, while at the same time preserving his conscious sense of autonomy. He was simultaneously choosing to be in a love marriage and choosing not to be in one, thus appeasing both himself and his parents.

To make this solution viable, of course, he had to deny that he was pleasing his parents in any way. However, he also had to turn a blind eye to the fact that he was acting in ways that were destined to make his marriage fail.

His depression was a defense mechanism in the sense that it protected him from looking at his own subjective agency in choosing whether or not to make his marriage work. His despondency and perceived powerlessness helped him avoid confronting an underlying conflict that would give him anxiety.

Psychodynamic Therapy Helps You Get to the Root of Your Problems:

Psychodynamic therapy helps people uncover the conflicts underneath their symptoms so they can reclaim control of their lives.

In the case of the Indian spouse, discovering the underlying conflict would make it possible for him to confront his guilt feelings so he wouldn’t have to unconsciously punish himself by making his marriage fail. By increasing insight into his psychodynamic conflicts, he would be able to address the real issue underlying his depression and his marital problems.

The Effectiveness of Psychodynamic Therapy:

Helping people get to the root of their problems, is precisely what makes psychodynamic therapy such a powerful treatment.

Research on psychodynamic therapy shows that not only is it effective in helping people resolve their problems, it even continues to increase its benefits after treatment ends. Because it does not only focus on immediate symptom relief, but allows people to confront what motivates their symptoms, psychodynamic therapy helps people gain control of what causes their distress.

By helping people gain insight into underlying causes that make it difficult for them to enjoy their life, psychodynamic therapy works much like the old proverb that says, “give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime”.

Rather than just feeding you a solution, psychodynamic therapy helps you get in touch with what produces the problem, so you can finally claim ownership of it rather than continue to pursue temporary “quick fixes” that only serve to cover the real problem up.

This is why I believe psychodynamic therapy.

Image_Moelbak_frontpage

About me: I am Rune Moelbak, Ph.D. a psychodynamic therapist in Houston, Texas. I help people get to the root of their issues. To book a therapy appointment, visit my website at: www.bettertherapy.com

image of couple arguing

How to Communicate with Your Partner without Starting a Fight

A frequent concern couples have is how to express their disagreements without starting a fight.

Learning how to communicate with your partner in a way that minimizes your partner’s defensiveness and makes it possible to have a conversation and not an argument is vital to the success of any relationship.

Having a conversation and having an argument are two very different things…

Argument:

In an argument, we try to convince our partner that we are right and that they are wrong. Oftentimes this leads to an escalation of conflict, because our partner is unlikely to simply agree that we are right, and is more likely to defend themselves or find convincing arguments why we are wrong. Even if our partner agrees with us, we may discover that it is a rather hollow victory: Our partner may simply have agreed with us to keep the peace, and may gradually end up becoming more distant from us, as they increasingly begin to feel that there is no room in the relationship for them to be who they are.

Conversation:

In a conversation, on the other hand, the focus shifts from convincing your partner that you are right to truly understanding your partner’s perspective. Even if you don’t agree about something, you can still attempt to understand what motivates each of your actions, and what feelings, beliefs, and perceptions underlie each of your complaints. The benefit of this approach, is that each partner can then feel heard and understood, and this typically brings partners closer to each other, and increases both partners tolerance and appreciation for each other’s differences.

How to Communicate without Starting a Fight: 

In the Gottman Method of couples therapy, couples are instructed to use the following guidelines in order to learn how to communicate without starting a fight:

Speaker:

  • Initiate a conversation in a soft rather than accusatory manner
  • Focus on your own experience, not on your partner
  • Focus on stating a positive need, instead of complaining about what your partner isn’t doing

Starting a conversation in a soft manner can be done in many ways. It can involve things like acknowledging that “you may or may not be right”, that “it is probably ridiculous to even bring this up, but…”, or that you don’t want to start a fight and you know that your partner is “doing many things right, but…” This is different from a more abrupt start up where you communicate that you feel entitled to your complaint and come across as self-rigtheous and accusatory.

Focusing on your experience means taking the focus off your partner, and sharing your own internal reactions, feelings, and interpretations. Instead of labeling your partner’s actions, or speaking about a situation in absolute terms, you turn the focus inward. Instead of saying things like, “it wasn’t right when you…” or “you were being very inconsiderate when you”, you instead look beneath your self-righteous anger and get in touch with your softer and more vulnerable emotions. Say something like, “I guess when you came home late again tonight (non-judgmental description), I started feeling lonely and started thinking that I wasn’t very important to you” Not something like, “you know you are always late, and I’m getting tired of sitting around waiting for you. It seems like you just don’t care about my feelings”

Focusing on stating a positive need instead of a criticism, means trying to pinpoint what it is you would like the two of you to do more of. In the example of your partner being late, the hidden need might be for the two of you to be closer with each other. Your sense of loneliness and disappointment when your partner is late, might be a clue that you have been feeling distant from your partner for a while. The trick now is to state what you want rather than what you don’t want. Instead of saying, “I’m tired of you being late”, you might instead say, “can we do more things together where we can connect with each other. I have been feeling rather lonely as of late”.

If you learn how to communicate with your partner using the three rules above, likelihood is that your partner will not feel attacked and will be able to actually listen and respond to your concern…

Listener:

If you are not the person voicing the complaint, but instead the one having to respond to your partner’s criticism, try to apply one of the following skills:

  • Don’t defend yourself or counter-attack
  • Validate your partner’s experience

Don’t defend yourself when your partner brings up a concern. Even if your partner may bring up an issue in an accusatory way, realize that underneath the anger, your partner likely feels hurt, rejected, or wounded in some way. Even if you notice yourself getting angry and ready to counter-attack, try to bite your tongue. Make a conscious decision to set your own issues to the side for the time being, and begin to listen for what your partner is really feeling and experiencing.

Validate your partner’s experience. You may not agree with how your partner interprets or sees things, and your partner’s feelings may seem quite irrational to you. This, however, is when you must make an effort to ask clarifying question to understand how your partner has arrived at his or her conclusions. You must try to find the logic in your partner’s perspective, so you can repeat your understanding back to them. Try to acknowledge and validate that if you were in their shoes, made the same kinds of interpretations, and had the same kind of values, you too would feel the way they do. Realize that by validating and saying that you understand, you are not saying that you agree, nor are you saying that your own feelings are invalid. In a relationship there is room for two valid perspectives on the same situation. The important thing is that both of you can feel that your perspectives are heard.

A Small Change Can Have a Large Effect:

Whether you are “the speaker” or “the listener”, it is important to realize that you can change an interaction by doing any of these 5 suggestions at any point in an interaction. Maybe your partner brings up a concern in an accusatory manner, and you decide to not respond in a defensive way, thus breaking the typical cycle of attack-defend. Or maybe you correct yourself in the middle of voicing your own complaint by making an effort to focus more on your own feelings than on labeling your partner’s. Each time you stop reacting to your partner and make a conscious decision to take control of the interaction, you increase the likelihood of turning an argument into a conversation. The benefits of learning how to communicate with your partner can be profound, so the next time you find yourself itching to let something off your chest, try using one of the five rules.

About me: I am Rune Moelbak, Ph.D. a couples therapist in Houston, Texas. I use a variety of proven methods to help couples get their relationships back on track. Visit my website to read more about my approach to couples therapy or to schedule an appointment.

Good Will Hunting

Is Talking Disappearing from Depression Therapy? (Commentary)

This week, a story in Newsvalley, asked the question “Is talking disappearing from depression therapy?”

The question followed the death of beloved actor, Robin Williams, who was reported to have been seeing a therapist for his depression in the period preceding his eventual suicide.

Robin Williams himself starred as a therapist in the award-winning movie Good Will Hunting, where his character touched the heart and mind of a troubled young man through the kind of talk therapy the article is wondering if might be disappearing.

Talk in talk therapy is of course a lot more than talk. It is about facilitating the kind of speech that evokes forgotten or suppressed feelings, and may never have been spoken before. It is creative or novel speech, not simply the rehashing of old events or the telling of stories. In and through speech people discover what they really think, just as is suggested by the expression: “to know what I think, I must first see what I say”. Speech, when it is therapeutic, or spoken from the right place, is a lot more powerful than we give it credit for…

We Are a Culture of “Doers”:

Unfortunately we live in a culture that does not value speech. The expression, “she’s all talk and no action” communicates that what matters in life is to act, and that thinking and talking are simply pre-stages to actions.

When Democrat John Kerry ran for president a while back, I remember with amusement, how Fox News spun his trip to France as an indicator that he was an “intellectual” not a “doer”. In America we don’t sit around thinking lofty thoughts like the “French”, the newscasters suggested, we “get things done!” Ludicrous as this spin was, it likely struck an emotional cord with most Americans, who have been brought up in a highly competitive capitalist society and have been taught to value productivity and accomplishment above all.

This kind of action-orientation has also found its way into the field of mental health. The popular understanding of problems of living is that they can be mastered just like another work-assignment. Barnes and Noble is full of self-help books that promise amazing results through easy steps and suggestions for whipping oneself back into shape. They espouse the idea that thoughts can be “engineered” and that you can choose to act differently through various mind-tricks.

The Engineering of Depression Therapy:

This mentality has of course also found its way into the ranks of therapists who are quick to embrace this popular view of psychology as a toolbox of tips and tricks to master one’s issues. Undoubtedly driven by a popular demand for this kind of solution- and action-oriented approach to problems, therapists have been eager to adopt a new line of “technical” treatments for mental health problems.

CBT or Cognitive Behavior Therapy is quickly replacing the kind of relationship-based “talk therapy” that helped the character Will Hunting confront his depression. Therapists eager to meet the popular demand for quick solutions, and training programs eager to turn therapy into a technology, have rushed to embrace this newer more modern alternative to traditional talk therapy. Research studies are often touted as showing the superior benefits of CBT, and psychiatrists now prescribe it, like they prescribe a pill.

The Problem with CBT for Depression: 

Unfortunately, the kind of therapy that benefitted Will Hunting, would not have been accomplished through CBT. A person does not experience a transformation in how they feel about themselves by filling out worksheets, or approaching their problems by becoming more rational about them.

The cure of Will Hunting was an emotional cure. Robin Williams was attuned to Will Hunting and was able to work with him so that Will was able to speak new words, and speak them from a new place within.

This new place within has to be accessed and discovered in and through a gradual and unfolding process, where a person first has to become vulnerable. Will had to trust his therapist, not by some rational command to do so, but by having a new experience of relating to another human being.

In the process of deepening his trust, Will had to be made aware of all the barriers to letting his guards down, including his fears of his emotional pain, his anger at others, and a host of other feeling and reactions that this kind of therapy process evoked in him.

And of course, along the way, Will had to speak of these new or sometimes “old” (but forgotten) experiences so as to make them part of himself and part of his own spoken reality.

Our Reality is Made of Words:

As cultural beings, we live in our words. Our human reality is a spoken reality: a reality of meanings brought forth by words and ideas.

Existentialist philosopher, Martin Heidegger, talked about language as “the house of being”. By this, he meant that language gives our ambiguous reality a kind of permanency that we are able to live within. This kind of permanency can consist of a “common sense” understanding of the world, that we are not even aware of, but that we take for granted when we approach ourselves as a technical machine in need of a quick fix, or think of our problems as “issues” that should be managed, mastered, and controlled.

Will, however, needed to let go of control, not increase it, and he needed to speak from a place that was different from the place he inhabits in his day-to-day life. He did not need his issues to be turned into problems to be mastered like another work-assignment. He needed space and patience, so he could begin to hear the voices of his subdued and suppressed feelings. He needed therapy to be an experience, not a set of procedures or dictates convincing him to be more rational or act opposite to his feelings. He needed to stop “doing”, and start “listening”. He needed to let go of his need for mastery, so he could begin to receive a different wisdom from within.

The Best Therapy for Depression:

The kind of talk therapy provided to Will Hunting is in my opinion the superior therapy for depression.

Depression may temporarily be mastered through consciously challenging and rectifying irrational thoughts, but it cannot be cured until the emotions fuelling the irrational beliefs are experienced and reworked in and through the therapy.

What motivates us to act is not simply will-power and logical understanding. We are driven to act and to repeat patterns in our relationships by our feelings, not our thoughts.

CBT rests on the assumption that feelings are simply the bi-products of ways of thinking and that a conscious choice to think differently will also make us feel differently.

I believe this way of thinking is overly simplistic. Most times people can quite readily see that their depressive thoughts are quite irrational, but that does not change a thing. Simply telling somebody or telling oneself that one’s thoughts or feelings are not rational, or replacing them with a more rational alternative, does not have the power of conviction needed to truly transform how we feel about ourselves. The goal of therapy should therefore not be to increase mastery of our feelings through our reasoning. Instead it should be to bypass our reasoning altogether, so we can effect change directly at the emotional level.

Why Talking May Be Disappearing from Depression Therapy:

The problem with the kind of therapy “Will Hunting” received for his depression is that it is hard to sell to someone who has not yet experienced it. It is a bit like describing how great a hamburger tastes, or telling somebody how thrilling a roller-coaster ride will be, to somebody who has never tasted a hamburger or been on a roller-coaster ride. To truly understand it, you must experience it, and until you have, it won’t make much sense.

In addition, because people don’t understand talk therapy until they experience it, they don’t know to ask for it, nor do they even know they want it. This makes it a much harder sell than CBT, which readily fits with our common sense understanding that our problems are best solved by will power or by technique.

And yet at the end of the day, Will Hunting was transformed, not by doing, but by slowing down and getting in touch with something stirring within. His was a talking cure , not a technological intervention.

About me: I am Rune Moelbak, Ph.D., a psychologist in Houston, Texas. I am a therapist providing psychodynamic therapy for depression.

How to make up after a fight

Relationships: How to Make Up After a Fight (and Learn From It)

A sign of a strong relationship is not that you never fight or argue. Disagreements and arguments are inevitable when we are emotionally invested in someone. Contrary to popular wisdom, however, fights do not have to tear us apart, but can actually serve as pathways to greater intimacy… 

Couples who don’t fight can only avoid doing so by suppressing their feelings and withdrawing emotionally, and this is not a sign of a healthy relationship.

The secret to a fulfilling relationship is therefore not to avoid saying or doing things that will lead to a fight, but to be able to recover from  fights when they DO happen and to learn from them.

Unfortunately some couples never revisit each person’s complaints after the fight is over. Happy to be done with the disagreement, they table their concerns, not wanting to start another argument. The result is that the issues leading to the fight never really get resolved. Instead they will simmer in the background and become the cause of new fights in the future…

The Cause of Most Fights

Most couples think that what causes them to fight is the expression of their needs and feelings (saying what they really think and feel). In most cases, however, this is not true. Fights usually happen because needs and feelings have NOT been expressed. The fight often erupts because one partner has finally had it and can’t stuff their emotions anymore.

What many couples fail to see is that having an argument is not the same as having a conversation.

When we argue we hurl out accusations. We are tired and fed up. We want our partner to feel sorry. We say things out of anger.

Of course this rarely works to our advantage, because our partner now feels attacked and stops listening to what we are saying.

Having a conversation, on the other hand, is about expressing yourself in a non-accusatory manner that will allow your partner to listen, and for both of you to feel understood.

Most couples fear revisiting the fight they had yesterday because they are afraid that it will simply restart the fight. They don’t know HOW to have a conversation about their issues that doesn’t turn into a fight.

But issues don’t go away just because we don’t talk about them. This is why it is important for any couple to have the skills to have the conversation that never took place.

The Aftermath of a Fight:

Couples therapist and researcher John Gottman has developed a step-by-step exercise couples can use to revisit their fight when they are calm and address the real issues that fuelled the fight. When these conversations happen they can strengthen a relationship and even be a source of greater intimacy between partners. They also tend to decrease the build-up of frustrations that will otherwise lead to fights in the future.

5 Steps to How to Make Up After a Fight:

 Here is my own modified version of Gottman’s method for how to make up after a fight and use disagreements as a source of greater connection: Sit down when you have both calmed down and are not busy or distracted and agree to revisit what happened the day before. Each person will take turn expressing their side of the story and will follow each of the 5 steps below:

1. Identify and Share How You Felt

Yesterday you were angry, but did you really stop to think what emotions fuelled the anger or why you reacted so strongly to certain things your partner did or said? It is often the case that softer and more uncomfortable emotions are hidden underneath our self-righteous anger. Have a look at the following list of feelings, to see if any of them might have been true for you:

I felt…

  1. defensive
  2. not listened to
  3. feelings got hurt
  4. totally glooded
  5. angry
  6. sad
  7. unloved
  8. misunderstood
  9. criticized
  10. took a complaint personally
  11. like you didn’t even like me
  12. not cared about
  13. worried
  14. afraid
  15. unsafe
  16. tense
  17. I was right and you were wrong
  18. Both of us were partly right
  19. Out of control
  20. Frustrated
  21. Righteously indignant
  22. Morally justified
  23. Unfairly picked on
  24. Unappreciated
  25. Disliked
  26. Unattractive
  27. Stupid
  28. Morally outraged
  29. Taken for granted
  30. Like leaving
  31. Like staying and talking things through
  32. I was overwhelmed with emotion
  33. Not calm
  34. Stubborn
  35. Powerless
  36. I had no influence
  37. I wanted to win this one
  38. My opinion didn’t even matter
  39. There was a lot of give and take
  40. I had no feelings at all
  41. I had no idea what I was feeling
  42. Lonely
  43. Alienated
  44. Ashamed
  45. Guilty
  46. Culpable
  47. Abandoned
  48. Disloyal
  49. Exhausted
  50. Foolish
  51. Overwhelmed
  52. Remorseful
  53. Shocked
  54. Tired

2. Describe the series of events that led you to feel this way

Help your partner understand how you perceived the events unfolding the day before (what led up to the fight? what made you react? and how did the fight unfold?). It is important in this step to speak from your own point of view: Describe yourself and your perceptions from an objective and detached perspective, like a witness giving an account of what they observed on a crime scene. Don’t guess your partner’s intentions and don’t assign blame. Simply focus on your interactions and how you perceived or interpreted what you heard or what your partner did. Instead of saying “when you didn’t care how I felt”, say “when you walked out during our fight, it made me think you didn’t care”. In other words, focus on how YOU made sense of the events, acknowledging that another person might not have interpreted events the way you did or assigned the same meaning to them.

3. Identify and talk about sensitivities that might have been evoked and where these sensitivities might come from

This is your chance to reflect a little bit about why you might be particularly sensitive to certain feelings, fears, or beliefs. Did feeling unloved remind you of something in your childhood? Did your fear of your partner leaving, remind you of how lonely you felt as a child? Are there times in the past when you have felt similarly to how you felt in the fight? If so, why do think you react so strongly to this particular feeling? What memories do you have involving that feeling? Is there a particular story you can you tell of a time in the past when you felt that way? Help your partner understand the underlying meaning or importance of a particular thought or feeling that you are very sensitive to.

4. Validate you partner’s perspective

When one partner goes through these 3-steps, the other partner’s job is to listen, ask open-ended questions, and clarify to make sure they understand. The listener should not defend themselves, or argue against the other person, but simply try to “get” why the other person reacted how they did. Validating means conveying to your partner that you understand why they reacted the way they did. To validate your partner is not to agree that your partner is right, and you are wrong. It is simply to convey that given a similar set of circumstances, and a similar way of interpreting events, you too would feel the way your partner does. It is important for your partner to hear that you get them, even if you don’t see things their way.

5. What can You do to be Sensitive to Your partner’s Needs and Feelings in the Future?

A final step, which isn’t always necessary, is to have a conversation about what each of you might be able to do differently so as to take each other’s sensitivities and needs into account. I say it is not always necessary because when you truly understand your partner’s reactions and experiences, it naturally follows that you will be more caring towards your partner and more sensitive to their needs.

Next time you have a fight, try to follow this 5-step model of how to make up after a fight. You might discover that disagreements do not have to threaten your relationship, but can actually be a source of greater intimacy and connection. 

About me: I am Rune Moelbak, Ph.D., a couples therapist in Houston, Texas. If you would like more insight into how to communicate more effectively with your partner, click here to get your FREE copy of “The Secrets of Happy Couples: A User’s Guide to a More Fulfilling Relationship”

Book cover for Free couples guide

Man wondering if he has a personality disorder

Do I Have a Personality Disorder?

We all have personalities, but what does it mean to have a personality “disorder”?

What is a Personality?

A personality is a certain habitual way I deal with the world around me. When you think to yourself “boy, that person sure has a personality!”, what comes to mind is probably certain predictable characteristics that stand out about them and that don’t just blend in with the surroundings.

Our personality is a collection of enduring traits about ourselves that make us stand out as well as make us predictable. Hence, I might tend to be “the life of the party” or the “loner”, the eternal optimist or the perpetual worrier, the workaholic or the worka-phobic, the antagonist or the person who always tries to please.

Whatever the case, my personality uniquely equips me to deal with certain situations, while it puts me at a disadvantage for dealing with certain others. My greatest strength in one context – becomes my greatest weakness in another…

My personality serves as a kind of immune system that protects my own mental health from the challenges and demands of life. It consists of a collection of go-to coping mechanisms and thinking styles through which I confront the world.

My personality is my specific way of dealing with the demands of life, such as creating a satisfying social life, succeeding in my chosen career, collaborating with others, developing close relationships, and dealing with interpersonal conflicts.

When things go well in life, that is, when my traits or tendencies match with my environment, then I can likely live a symptom-free life. However, when there is not a good match, tensions will begin to rise within me, and I am likely to become depressed, anxious, angry, or otherwise unhappy.

John has a Personality Disorder:

John loves to be “the life of the party” and uses this trait to his great advantage. He becomes an actor so he can feel the thrill of being on stage, and has a very active social life that satisfies his need for attention. His personality helps him succeed in areas of his life that are important to him.

Yet John might begin to get in trouble if he ALWAYS has to be the life of the party, if he NEVER can be alone with himself, or if he ALWAYS relates to others as an entertainer, actor or performer.

He may for example meet a romantic partner he likes, but due to his chronic and excessive need for attention, may make every conversation about himself.

With his excessive focus on his own needs, John may not be able to be empathic with his partner’s needs and may not be able to maintain the mutuality required to create an intimate relationship.

When his partner begins to feel dissatisfied with John’s excessive attention-hoarding and demand that something changes, John may not be able to give in to the demand, since doing so would make him feel depressed, unloved, or empty.

He therefore instead turns the blame back on his partner whom he accuses of just not being that interesting and therefore being responsible for his own misery.

When his partner withdraws his interest in the relationship and in John, John does not have the flexibility in his personality to allow himself to notice this, so he instead “tells himself a story” and tries to convince himself and his friends that everything is fine.

When his relationship finally falls apart, John might at first become self-righteously indignant. He may seek out friends who can confirm his belief that his partner is to blame. He may also launch himself into a string of affairs to confirm to himself how lovable he is and therefore prove that “it is his partner’s loss” — not his

However, if these strategies fail, John may eventually have no way to maintain his fragile self-esteem and may finally have to engage in some painful soul-searching. At this point he is likely to become depressed, may begin to drink, or may not be able to maintain work obligations or friendships.

What is a Personality Disorder?

John would likely be diagnosed with a personality disorder.

His character traits are rigid. If people around him do not adapt to his preferred ways of dealing with situations, John cannot change his approach and adapt to the new situation.

As a result, John is bound to have many conflicts with people around him, and frequently be at odds with the demands placed on him by different tasks or role expectations.

In John’s situation, differences between personality style and environment are solved by devaluing the environment or changing the environment, which works as long as other people are ready to accommodate him.

In other personality types, such as in people with strong dependency needs or excessive fearfulness, differences may be solved by acquiescing, letting go of healthy assertiveness, or abandoning oneself.

In either case, the environment threatens the integrity of the person’s self-esteem and makes it impossible for them to learn from the situation and master a greater repertoire of skills. The person tends to always respond the same way regardless of circumstance and is thus locked into a cycle of repeating the same failed outcomes.

John, for example, may fall in love again, but his next relationship will likely have the same ending, since the need for admiration is the only way John knows to raise himself out of an ever-looming depression.

This then leads to another hallmark of people with personality disorders: They tend to run into the same problems time and again. Depending on their personality style they may show patterns of getting fired due to having trouble taking orders from a boss, falling out with friends due to inability to deal with conflicts, getting divorced on multiple occasions due to the same complaints by their spouses, and so on and so forth…

Personality Disorders are Dimensional:

We all have certain rigid and unbendable traits that can get us in trouble in life and can make it difficult to deal with the demands of particular situations. With each personality comes certain advantages and disadvantages. This is to be expected. Most of us reduce tension and discomfort by creating a life that maximizes our advantages and reduces the need to be someone we are not. This does not mean that we have a personality disorder.

Our personality only becomes a severe liability when we feel chronically deficient in the many aspects needed to live a fulfilling life. We may for example not be able to tolerate intimacy regardless of circumstances, or may not be able to EVER relax or be spontaneous, or may not be able to enter into ANY relationship without sexualizing it. It is in these cases that assigning the label of a personality disorder may be appropriate.

Having a personality disorder is therefore not simply about having a personality trait or habit that gets us in trouble. This trait must be so rigid, so exclusionary of other ways of doing things and perceiving the world, that it severely limits our ability to function effectively in life. Hence there is a difference between being perfectionistic, and not being able to complete a work assignment because one is never satisfied with the result.

Many traits only become dysfunctional when taken to a certain level of intensity or severity. In the first case, perfectionism might help me win awards for my attention to detail, while in the latter, my perfectionism might end up getting me fired.

Therapy for Personality Disorders:

If your personality prevents you from getting along with others, functioning well at work, or getting enjoyment out of life, the treatment of choice is not simply to force yourself to act differently. The rigidity of particular personality traits is often the result of bruises to self-esteem, or early developmental traumas. Particular ways of dealing with tension, psychic pain, and threats to self-esteem developed as a kind of protective armor needed to deal with threats to one’s psychological safety.

Psychodynamic therapy is particularly effective in helping people access these early experiences and traumas so they can be begin to grow from life, rather than remain stuck in the need to protect themselves from it…

About Me: I am Rune Moelbak, Ph.D., a psychodynamic therapist in Houston, TX, who helps people get to the root of their problems. Visit my website to schedule an appointment.

picture of therapy couch

Psychotherapy: Does Therapy Work?

Many people who are considering therapy for their psychological difficulties, may wonder how effective talking about their problems is really going to be… So let’s examine the question: Does therapy work?

What’s Wrong with Talk Therapy?

The concern about whether or not therapy works, might not be assuaged by reading a recent Time Magazine opinion piece, that questions the legitimacy of longer term talk therapy. In the piece, entitled “The Trouble with Talk Therapy”,  neuroscience journalist and author, Maia Szalvitz, argues that most therapists have no clue about the latest and most effective treatments for common psychological problems. Instead they want to “go deep” to uncover unconscious feelings and motivations, which she says, has not been found to be effective in treating problems like Obsessive Compulsive Disorder, Depression, Anxiety, and Post Traumatic Stress.

The problem, she says, is not that effective treatments don’t exist for these problems, but that therapists either don’t know of them, or choose not to make use of them.  She cites Alan Kazdin, who is the former president of the American Psychological Association, for saying that “Most of the treatments used in clinical practice have not been evaluated in research.  Also, many of the treatments that have been well established are not being used.”

As a result, Szalavitz claims, she has a hard time knowing where to refer herself or her friends for effective treatment, for as she concludes, talk therapy has an “evidence” problem…

What’s Wrong with Szalavitz’s and Kazdin’s Argument? 

Psychological distress cannot be separated from who you are as a person:

Szalavitz and Kazdin are asking the right questions, but on the basis of a wrong understanding. Their assumption is that psychological problems are “disorders”, and that “disorders” can be treated like one treats a medical illness. Hence there should be one best treatment for depression, one best treatment for OCD, one best treatment for anxiety, and so forth.

The problem with that understanding is that it is based on ignoring the subjective meaning and function of our psychological distress. What makes a problem psychological is precisely that it involves the life of the person. This means that I can be depressed for different reasons than you and that your obsessions and compulsions can serve a different function in your life than they do in mine. OCD and depression are therefore not phenomena that exist in some objective reality where they can be treated using some standard method that gets applied the same way to each person. Instead they are surface manifestations of underlying psychological conflicts and issues that are highly particular to each individual. If we want to get to the root of the problem, we must therefore make these particular conflicts and issues the real focus of the therapy.

Psychological issues are intertwined, not separate from each other:

Szalavitz and Kazdin also make another mistaken assumption. They believe that problems like anxiety, depression, obsessions, and compulsions exist independently from each other, making it the case that one can focus treatment on a single problem and select the best treatment technique for each problem.

In actuality, however, most people who come to therapy have a variety of psychological issues that cut across identifiable “disorders”. They bring their life to the therapy, not an illness. Any therapist is likely to agree that the longer one works with a client in therapy, the harder it becomes to provide a diagnosis. As the complexity of our understanding of our clients increase, so does the inadequacy of any particular label or diagnosis. People are first and foremost people and as they expand their own understanding of the interconnections between their symptoms and themselves, the need to localize and separate their problems from who they are as people tends to disappear. As the now deceased Dutch psychologist, J.H. Van den Berg, has pointed out, people come as wholes, not as fragments, and one cannot focus on a single area of a person’s life without implicating all the others. One cannot lift the corner of a carpet, without lifting the whole carpet…  

Psychotherapy focuses on subjective truth, not objective knowledge: 

A third mistake Szalavitz and Kazdin make is that they fail to appreciate that there are two different truths and realities in life. Science deals with objective truth and objective reality. It deals with “facts” based on unbiased observations and treats these facts as universal truths rather than contextual truths.

Psychotherapy, however, deals with subjective truth and subjective reality. Subjective truth and subjective reality are not a lesser truth or lesser reality. In fact, our subjective experience is often what is most instrumental in motivating our behaviors.

To illustrate the difference, let me provide an example: If a male client can’t grieve the death of a close friend, this is not because he is objectively incapable of grieving or crying, but may be because he subjectively believes that “real men don’t cry”. This subjective reality, which he may or may not be aware of at the start of the therapy, can explain his lack of ability to grieve. It also provides “evidence” for why he may objectively present as depressed. Natural grief that is being suppressed may turn into a heaviness that cannot be released and may lead to a lack of contact with vital emotions that manifests  as symptoms of depression.

In therapy, however, the client may not initially be aware of this subjective belief, nor would the therapist know of it simply by looking at the client’s objective symptoms. The secret to understanding the client’s depression thus lies in a subjective truth that must be discovered, not in an objective knowledge that can be said to be universally applicable each time somebody shows up as depressed.

Why Psychotherapy Cannot be Standardized… 

What Szalavitz and Kazdin don’t understand is that therapy is not factory work and is not about providing prefabricated treatments of objective problems. It is about understanding the unique subjective causes that motivate and explain surface level symptoms that may look the same, but have widely discrepant reasons for being. This means treating the “person”, not the “disorder”, for the person explains the disorder and not the other way around.

So Back to Our Original Question: Does Therapy Work?

I believe the answer is yes, but it works in a very different way than a coffee maker works to make coffee or an oven toaster works to make toast. It helps people discover their own subjective truths, and not simply to change a behavior. Following Szalavitz’s and Kazdin’s advise is to apply a logic that may very well work in the realm of machines and objective cause and effect, but is very ill suited for the likes of us

About me: I am Rune Moelbak, Ph.D.,  a psychodynamic therapist in Houston, Texas. If you are interested in learning more about how a psychodynamic approach can help you get to the root of your problems, click here.

image of people having an affair

Extra-Marital Affairs: Why Do People Cheat?

Infidelity and Cheating is Widespread:

Statistics show that between 35-50% of all women or men in a relationship have had an affair. With such widespread occurrence of infidelity, affairs cannot only be attributed to some act of deviance or amorality, but must be looked at as a normal fact of life.

This begs the question “why do so many people cheat?” And, “What are the challenges to staying faithful and monogamous in a relationship?”

Is There Something Wrong with Cheating?

Over the years psychologists and sociologists have advanced many viewpoints on this matter. The current stance of many couples therapists seems almost naively moralistic and judgmental, focusing mostly on the “victim’s” right to feel angry and the perpetrator’s need to atone. They implicitly turn cheating into a simple selfish act, a violation of social norms, and a sign of immaturity.

And yet, aren’t we all fascinated by the forbidden? Doesn’t the forbidden actually enhance our eroticism? Have we not all been tempted by the lure of what might exist on the other side of the fence?

If we dig deeper into our unconscious we will find that most people, whether they admit to it or not, have been tempted to cheat, have fantasized about somebody else than their spouse, and have found secret emotional fulfillment with others without wanting their spouses to know.

Judging Our Desires Can Lead to Cheating

Oftentimes what propels a person into an affair is ironically their lack of ability to talk to their spouse about their deepest darkest fantasies. The prohibition against having an affair is thus often what makes it happen. The affair becomes the actual outlet, for what cannot be talked about within the existing relationship. What gets denied, goes underground, only to become expressed through actions and impulses in another setting.

A chronic problem in intimate relationships is the inability to openly admit to and share fantasies and urges that are not considered “right” or “proper”, and that one does not feel a decent human being “should” have. Because there is then no room for it within the relationship, there is also no room for a part of the person. This part is then forced to exist in secret and to be siphoned off to a parallel reality, whether it be internet porn, a secret lover, or a clandestine emotional encounter. People’s fears of confessing and being a 100% themselves within a relationship thus leads to a pressing need for more than one relationship to contain all parts of oneself.

In some relationships, this fact of life is openly embraced. Hence we have communities of swingers, people who agree to have open relationships, or people who agree to have threesomes. Some report that this greatly spices up their life and reduces the need for their partner to secretly cheat, but others suggest it comes with its own dangers, and leads to unmanageable jealousy that tends to ultimately break people apart.

Why Do People Have Affairs?

People who have been cheated on and have felt the betrayal of an extra-marital affair, may end up blaming themselves, thinking that they were deficient in some way. Oftentimes, however, partners who cheat are struggling with their own issues (like all of us), which make it difficult for them to get all their needs met with one partner, no matter who that partner is.

A common problem encountered by men is the “Madonna – Whore” complex, by which tender feelings originally felt toward a person’s mother, cannot be reconciled with a person’s “dirty” sexual desires. In this case, a person will thus have a need to relate to their spouse as a good friend and revered mother, and live out their sexual fantasies with a “lover” whose only function is to serve as a sexual outlet for these unaccepted desires. It is for example not uncommon for someone to not be able to have great sex with a person they respect, and to have great sex with someone whom they don’t really respect much as a person.

Another common situation is for a person to recreate a relationship with their spouse that makes them feel trapped, stifled, and in need of an escape. A person may for example unknowingly contribute to a relationship where they feel lonely and unloved, and find themselves in need of getting those needs met elsewhere. It is thus not uncommon to find that the person feeling lonely has withdrawn themselves and stopped sharing the personal thoughts and feelings that would have made them feel more loved and intimate. At the end of the day, we therefore sometimes unconsciously create the very types of relationships, which we then find insufferable. A true test of this is whether or not the next relationship tends to end in the same situation, making break-ups and infidelity a sort of coping mechanism that substitutes for dealing with one’s own barriers to establishing a fulfilling intimate partnership with someone.

A Common Factor that Leads to Infidelity:

The list of why we cheat is long and often involves complicated personal and interpersonal dynamics. But one thing seems to be true across the board: Cheating seems to happen when a part of the person cannot be expressed within the confines of a single relationship. There are many reasons why this cannot happen, but the root cause is often the lack of ability to create, and tolerate, intimacy, and the inability to be completely oneself within one’s existing relationship…

About Me: I am Rune Moelbak, Ph.D., a psychologist in Houston, Texas. I use a non-shaming and non-blaming approach to working with individuals who feel guilty about having an affair, and couples who are struggling with issues of infidelity. Click on this link to read more about my approach to couples therapy…