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Thursday, June 29, 2017

The Takeaways from The High Conflict Couple

The Takeaways from The High Conflict Couple
This blog serves as an overview of the book "The High Conflict Couple," and how the concepts apply to military populations.

I frequently read through the reconciled data from our workshop evaluations in order to make programmatic decisions. Given the mass of requests for Dialectical Behavior Therapy (DBT) training & our upcoming training on Integrative Behavioral Couple Therapy with Veterans & Their Partners, I felt inspired to read The High Conflict Couple, by Dr. Alan Fruzzetti. This book is a practical guide for couples to implement DBT skills into their relationship. Through reading this book, I noticed a frequently occurring theme that particularly applies to the veteran community. The theme being that it makes sense. It makes sense that emotions are expressed (or not expressed) the way they are; that validation is a foreign concept; that conversations are handled the way they are. All of this makes sense.

  • It makes sense that emotions are expressed (or not expressed) the way they are
  • In DBT, there are 10 recognized emotions: anger, sadness, joy, love, fear, disgust, guilt, shame, envy, and jealousy. When one of these emotions is cued we experience that primary emotion. The experience of the first emotion, or after effects thereof, will often result in the experience of a secondary emotion. Many schools of thought, DBT included, see anger as most often occurring as a secondary emotion. The High Conflict Couple, went on to explain that our primary emotion may “fit the facts” (ex. any reasonable and prudent person would experience sadness when they have lost someone close to them), but our secondary emotion (ex. anger that I lost an item) does not “fit the facts.” What I very much enjoyed about this book is that “not fitting the facts” did not equal “bad.” Dr. Fruzzetti did a fantastic job explaining that the secondary emotion serves as a warning/red flag that something needs to be addressed. This could be that we need to address our judgments, negative self-talk, physical health, reaction to the primary emotion, etc. Veterans often get type-casted as ‘angry,’ with this new information, what changes for you and your work with this community?

    All people walk into situations with a certain amount of emotion vulnerability. Things that contribute to emotion vulnerability are biology (predisposition to experience big emotions), how well we have cared for ourselves physically, and history to name a few. With emotion vulnerability, generally, heightened emotional arousal will occur and with that we may inaccurately express our emotion. An example of such is: John is sad that his wife has to travel for business two times this month, when he speaks to her about this he ends up yelling something like “You always leave me here to deal with everything!” John is sad, but his expression is yelling which is interpreted as anger. With John’s expression will likely come misunderstanding from his wife, subsequently resulting in invalidation (John’s sadness does not get soothed). It makes sense that this happens, and yet this scenario is cause for a lot of distress in many relationships.

  • It makes sense that validation is a foreign concept
  • As you could probably deduce from the last example, validation is very important. Validation is important to us and our relationships with others. What is interesting, is that research has shown that when we validate ourselves, it increases our ability to validate others. There are many components to validation, for a validation by level guide, click here.

    In the most basic of forms, validation is the acknowledgement and acceptance of thoughts, feelings, sensations, and behaviors as understandable. It is a crucial way in which we communicate to others & to ourselves. Again, it makes sense that many people do not learn validation. We are not born into this world innately with the skill to validate, we learn by what our environment modeled to us. In our Military & Veteran Culture workshops, we discuss why someone joins the military. Among others, a common reason is to “get away” from whatever home environment they come from. That said it would not be unreasonable to assume that many military members did not learn validation in their home environments. Now, we place that individual in an environment much stronger than them, which cares solely about the big picture (mission). Thoughts, feelings, and sensations do not have a part in the military. How do we, as service providers or family members, teach this crucial skill to our veterans? To start: validate that it makes sense that they do not know how to validate (or that they do not understand the importance of validation!).

  • It makes sense that conversations are handled the way they are
  • Taking into consideration the way emotions are expressed and the role invalidation/validation plays, it makes a ton of sense how conversations can go awry. For example we may create our own invalidating environment unintentionally (I will colloquially call this “reverse invalidating environment”). Here’s an example from the text: “Your partner may say ‘honey, you look tired. Maybe you should go to bed early,” you respond by saying “No thanks, I’m okay.” This interaction is not inherently ‘bad,’ but it does prohibit the partners from being able to connect, repair, or be authentic; subsequently causing a cascading effect of invalidation towards self and their partner. To be authentic means to be upfront about our needs and wants. As Dr. Fruzzetti says: “When we go to a restaurant, we don’t say to the waiter ‘I’m hungry.’ We have to say what we want, or we can’t expect to get it very often by chance.”

    Another thing that tends to get in the way of productive or effective conversations is the inability for one or both partners to use distress tolerance skills to bring down the emotional response. A common question I get from veterans is “How do I use distress tolerance if I can’t get away?” When the environment is stronger than the person (like the military tends to be) or for whatever reason there is the perception that they cannot get away, how can distress tolerance happen? The short answer: it depends on the situation. When the environment is stronger than the person, it may be an appropriate time to develop a cope ahead plan. For the latter, you may have to read the book to get the answer!

    Fruzzetti, A.E. (2006). The High Conflict Couple. Oakland, CA: New Harbinger Publications.