The Importance of Peer Consultation

Rhonda and David are joined today by Dr. Michael Greenwald, who was in the studio following his recording of last week’s podcast. We address a fascinating question submitted by a podcast fan:

Sally asks” “How can I help my depressed husband who is leaving me?”

Hello Dr David,

My husband is going through severe depression and anxiety. He blames me frequently for all the bad decisions he made, and he says he married the wrong woman.

He regrets almost every decision he made and says he made the decision [to marry me] under my pressure. Our marriage of 20 years is almost leading to separation.

I don’t want to separate, but I don’t know how I can improve the situation. He doesn’t want to go to any doctor.

Do you think if I decide to go to TEAM certified therapist, they can work on me to get him out of his depression? If yes, how many sessions will it take?

Sally

David, Rhonda and Michael discuss this sad and difficult situation that Sally describes. Feeling loved and cared about is vitally important to nearly all of us, and when an important relationship is threatened, it can be extremely painful.

It sounds like Sally's husband may be on the verge of leaving her. David describes a powerful and paradoxical strategy he described in Feeling Good: The New Mood Therapy, that he has often used to help abandoned wives. The approach is the opposite of "chasing," and is based on experimental research on the most effective ways of shaping the behavior of rats!

It also sounds like Sally and her husband have some significant difficulties communicating in a loving and supportive way, like nearly all couples who are not getting along, and certainly some couples therapy or consultation might be a useful step. However, the prognosis for couples therapy isn't terribly positive unless both partners are strongly committed to each other, and willing to work on their own problems, as opposed to trying to change or “fix” the other person.

We place a strong emphasis on the Five Secrets of Effective Communication, especially the listening skills, when criticized by a patient, family member, colleague, or just about anyone. If Sally committed herself to learning to use these skills—which are NOT easy to learn—she might be able to develop a more loving and satisfying relationship with her husband, whether or not they separate or stay together. David expresses the opinion that her fixation on “helping” or “fixing” him might be misguided, and might actually irritate him and drive him away.

Rhonda, Michael and David illustrate David’s “Intimacy Exercise,” which is a way of learning to use the Five Secrets, and they practice with three of the criticisms Sally has heard from her husband:

1. “You pressured me into marrying you.”
2. “You’re to blame for all the bad decisions I’ve made.”
3. “I married the wrong woman.”

After each exchange, the person playing Sally’s role receives a grade (A, B, C, etc.) along with a brief analysis of why, followed by role-reversals. These role play demonstrations might be interesting and useful for you, too, because you’ll see how this exercise works, and your eyes will also be opened to just how challenging it can be to respond to a painful criticism in a skillful way, and how mind-blowing it is when you do it right. You will also see that trained mental health professionals often make mistakes when learning these skills, and how you can increase your skills through this type of practice.

David emailed Sally with some additional resources that could be helpful to her.

Hi Sally,

Thank you so much for your question, and for giving us the permission to read and discuss your question on a podcast. We will, however, change your name to protect your identity.

For referrals for treatment, you can check the referral page on my website,  or go to the website of the Feeling Good Institute. There may be some excellent therapists in your area, too.

I would recommend the recent Feeling Good Podcast on “How to Help, and How NOT to Help.” . The idea is that listening is sometimes far more effective and respectful than trying to “help” someone who is angry with you.

Also, the podcasts on the Five Secrets of Effective Communication, starting with #65, could be helpful, along with my book, Feeling Good Together. There’s also search function on almost every page of my website, and if you type in “Five Secrets,” you’ll get a wealth of free resources.

Your husband might benefit from my book, Feeling Good: The New Mood Therapy, available on Amazon for less than $10. Research studies indicate that more than 50% of depressed individuals improve substantially within four weeks of being given a copy of this book, with no other treatment. However, the depressed individual must be looking for help, and it’s not clear to me whether the treatment is more your idea, or his idea.

You seem to be asking for training in how to treat your husband. Perhaps, instead, you could learn to respond to him more skillfully and effectively using the Five Secrets. Learning how to do psychotherapy requires many years of training, and since he is not asking you for treatment or for help, that plan does not seem likely to be effective, at least based on what I know.

In fact, trying to “treat” someone who is clearly annoyed with you runs the danger of creating more tension and anger, but this is not consultation, just general teaching. You would have to consult with a mental health professional for suggestions. Obviously, we cannot treat you or make any meaningful treatment recommendations in this context.

But there is no doubt in my mind that there are many things you can do to improve the way you communicate with him and relate to him, if that would interest you. But this would require looking at your own role in the relationship, as well as lots of hard work and practice to learn to use the Five Secrets.

Sincerely,

David D. Burns, M.D.

Thanks for listening to today's podcast!

David