Saturday, December 28, 2013

The Basics of Relationship Therapy: Knowing What You Feel

Bill, a software company manager with sandy hair and bright blue eyes, first came to see me when he was 35 years old. He was married to Anne, an attractive brunette who was a full-time mom to their three-year-old son, Cody. After living with Anne for five years, Bill had lost touch with the good feelings he once felt, and he was getting tired of the same old routine in their relationship.

For one thing, Anne no longer seemed interested in Bill's attempts at romance. When he wanted to make love, she always seemed to have five household projects that needed to be done. While there was a time when each would drop everything to be sexual, those days were long gone.

Bill brought home flowers after work to surprise Anne, but she scolded him, saying they could not afford to spend that kind of money while raising their son. Deep down, Bill felt hurt and angry because he was trying to do the little things that Anne used to like. However, like millions of guys, he did not really know what he was feeling other than a general down feeling. When he felt this discomfort with Anne, he handled it by making impulsive sarcastic comments. At other times he would spend hours at the computer, something he knew she disliked, just to get even with her.

Building a Brick Wall

A brick wall was gradually going up between the two of them, and their love was getting buried. As the wall went up, Bill began to have fantasies about being with other women. He started going to lunch with a friendly female co-worker who made Bill feel like he was attractive, important and appreciated.

Bill secretly began looking for an apartment, thinking he may want a separation. He was tired of the chronic fighting with his wife, but every time he looked at an apartment, he couldn't help but wonder if this was what he really wanted. Just thinking about leaving Cody made his heart race as he remembered too well his own upbringing in a broken home. Bill didn't want Cody to grow up with a dad he only saw on weekends. He wanted to give him the stability his father never gave him, but Bill didn't want to sacrifice his own happiness. He felt conflicted and confused.

When Bill felt lonely he ate more junk food, or he would binge drink (drinking alcohol with the primary intention of becoming intoxicated). He was spending more money on fast food while he was cutting back on his workouts at the gym. After Cody was put to bed, Bill would go out drinking with his friends or stay up late surfing the web. As his marriage was going down the tubes, chatting with girls on online dating sites was his favorite pastime. This, at least, brought a little excitement into his life.

The World of Instant Gratification

The media does a superior job of promoting instant gratification, and this was a problem for both Anne and Bill, as it is for a significant percentage of couples. Delayed gratification involves being able to contain and manage your feelings while listening to your partner, and many people do not want to tolerate this discomfort. Most people prefer instant gratification over delayed gratification, and it causes too many marriages to end up in divorce. Many of these marriages could become exceptional if people would learn to listen to their partners, ask good questions, keep their feelings on hold and delay gratification. During difficult discussions with Anne, Bill was impatient and found himself going around in circles, so he distracted himself with alcohol, junk food and web surfing instead of taking on the challenge of developing a strong marriage.

The truth is, far too many marriages and partnerships fall apart because people:

1. don't know what they are feeling,
2. distract themselves when they feel uncomfortable, instead of getting closer to their true feelings,
3. get highly defensive and reactive during conflicts, and
4. stop expressing themselves to their partners.

The result over time is the building of resentment, and love gets buried. As you get to know Bill, you will learn how he had problems with all four. Bill's most serious problem was self-medicating his pain with alcohol, which was putting him and others at risk.Periodically, Bill thought about seeing a relationship therapist, but he kept postponing it.

Getting Some Help

Bill made an appointment to see me shortly after a police officer stopped him for driving under the influence. He knew he was heading in the wrong direction and didn't want to jeopardize his job. Bill was honest about what was happening in his marriage and had the emotional health to see that he was partly responsible for his relationship problems.

He admitted to having a rebellious side, which came out in his sarcastic comments toward Anne and his desire to get back at her. He confessed to intentionally leaving open the dating website window in hopes that Anne would get jealous. The thought of telling her that he felt hurt and wanted to get even was something that never crossed his mind. It never crossed his mind because he was only dimly aware of these feelings, and slowly, brick by brick, he pushed away the person he really loved.

Bill gradually opened up about having some awareness of a deep depression that he traced back to growing up with an alcoholic father. As a young boy, Bill remembered feeling scared and hiding under his bed when his father was drunk and yelling. In many ways, Bill felt he had lost his father to the bottle when Bill was just a preschooler. Without healthy support from his parents, Bill never learned about core feelings like sadness, anger, fear, frustration, excitement and love/joy. When Bill tried to talk to his mother, she seemed absorbed in her own world, worried about her husband. Bill still remembered that pained look in her face whenever he tried to reach out.

He also never learned to differentiate, which is a development process that involves learning skills and refined subsets of skills while growing up. Since Bill never learned to identify his core feelings, it was hard to express what he wanted. This stifled the positive feedback from others that could eventually help Bill discover his true identity. The only way Bill could get essential nurturing and appreciation was to cater to his parents' needs, and thus he learned to put his feelings aside and hold back. Over time, this holding back drained a lot of energy that he could have used for valuable learning.

Bill began to struggle with anxiety when he was around 12 years old - he tossed and turned at night and sometimes just couldn't fall asleep. Sometimes he felt like he wanted to run away. He also felt boredom and a mild sense of depression that gradually progressed through his teen years. During those years, he longed for his dad to be there and support him, but instead he felt lonely and needy. This would have been an ideal time for Bill to do some relationship work.

It was clear to me that Bill was going to have a hard time quitting his drinking and getting to know his feelings because of his childhood history of stuffed-away pain. He admitted he was not able to stop drinking completely, but he rationalized that cutting back would be the answer. Bill had suppressed a lot of feelings for years but there was a wonderful opportunity to work through his feelings in individual therapy, and eventually, in couples therapy.

In the section below you will learn about some of Bill's experiences in individual therapy and some of the skills he needed to learn. To move toward cultivating an exceptional relationship, Bill first needed to develop a positive relationship with himself. This involved developing an awareness of his thoughts and feelings, from which he could make decisions about the actions he wanted to take. He also needed to learn how to express his feelings in a way that Anne could accept, if he was to save his marriage. Finally, it was important for Bill to realize that his drinking was self-destructive, and he needed to make a decision to quit.

Learning from the Past

It didn't take long to get a deeper understanding of why Bill had a difficult time knowing what he was feeling. Not only was his father a drunk, but also he had a family history of mood disorders.He thought his dad had bipolar disorder although it had never been diagnosed. Bill reported early problems in school - his teachers said he was often out of his seat and disrupting the classroom, and eventually his family physician diagnosed hyperactivity.

Apparently, some type of hyperactivity continued into his adulthood; I learned there were times when Bill would make irrational decisions about spending, such as buying a new car on a whim or planning a last-minute trip, without consulting his wife. Clearly, his impulsiveness was negatively impacting his life - when he came home with flowers, it only reminded Anne of these earlier episodes, and she instantly became critical.

Anne and Bill seldom took the time to hear each other out and were stuck in a cycle of defending their own positions. There was little understanding, so neither one could figure out a way to negotiate and return to harmony and health in their relationship. Their differences were leading to destruction rather than to the amazing relationship Bill and Anne secretly longed for.

Given his symptoms of impulse spending, the need for decreasing amounts of sleep and trouble slowing down, I referred Bill for a psychiatric evaluation. Dr. Filbert made a provisional diagnosis of bipolar II and anxiety. Bipolar II is a mood disorder characterized by periods of depression, normal moods and symptoms of hypomania. Hypomania includes such symptoms as restlessness, pressured and rapid speech, having endless energy but needing as little as 3 hours of sleep, involvement in numerous activities, silly behavior and irritability. The doctor prescribed an antidepressant and Lamictal, a mood stabilizer that helped Bill to slow down and connect more deeply with his feelings. Since he could better identify what he felt inside, the medication really helped Bill progress in therapy.

His homework in the early months of therapy was to identify whether he felt sad, mad, scared, excited and/or love. I had Bill keep a journal of his feelings and thoughts, and gradually he became more connected to his emotional side. He was able, at last, to talk with Anne about some of his pain, and fortunately she understood. He still had a lot of work to do because he needed to learn self-calming skills for the agitation that was part of his bipolar II condition, and he also continued to carry a lot of suppressed pain about his father..

Bill shared with me that his parents were divorced when he was 15 years old. He felt guilty during that time because he believed, on some level, that he was the cause of their divorce. His dad left at a time when Bill needed his guidance, and Bill felt a responsibility to care for his grieving mother. These conditions made it nearly impossible for Bill to develop good connections to his feelings. Also, he had never learned to tolerate uncomfortable feelings or to talk out problems in the context of a significant relationship. Essentially, Bill lacked role models for a healthy adult intimacy.

Like Bill, there are people of all ages who try, at all costs, to avoid their feelings. Addictions of various sorts such as drugs, gambling, sex, alcohol and even food are all known to self-medicate emotional states that people think they can't tolerate. Conflict avoidance is another serious problem in relationships where adults lack effective listening skills and are out of touch with the depth of their feelings. The bottom line is that people can tolerate a lot more than they think, and these skills can make an amazing improvement in communication and intimacy.

Developing strong connections with feelings and being able to both contain and appropriately express those feelings are essential to mastering the challenges of life and developing exceptional relationships. Most people want to achieve important goals in their lives, but many don't succeed because they have not learned how to identify their feelings, tolerate the discomfort of negative emotions and stick with a plan to reach an important goal.

Learning How to Identify Your Feelings

Healthy people know what they feel and what to do about it. This was hard for Bill to figure out because of his long history of burying his feelings. With some work in therapy, Bill gradually learned to identify more fully with the range of his feelings. He learned to hang out with his uncomfortable feelings long enough to know what he was feeling, and then he could put action on the feeling. But just how do you go about learning this important skill?

Learning to identify and contain your feelings will take some time, but it is worth every minute. Here are the five main steps in the process:

1. Schedule some quiet time to be with yourself.

2. Focus inward on one event in your day where you had an emotional response, and make notes about what you felt and thought. Remember the core feelings -- do you feel sad, mad, scared, excited, frustrated or love/joy?

3. Stay with your feelings long enough to become clear about what you are thinking and feeling.

4. Let yourself journal about whatever comes to mind so you can go deeper into your emotions and generate options from this connection.

5. When you feel confused, stick with the process till you get somewhere.

Journaling is a great way to get connected with your feelings, and I will share a sample of Bill's journaling below. This will enable you to understand his internal struggle and see how journaling can help you get in touch with your feelings. In this journal section, from early in his therapy, Bill was mainly grappling with his feelings toward Anne (the content has been changed for confidentiality):

What's on my mind? Mostly I am connected to negative thoughts about Anne. She is such a control freak, and all she cares about is keeping the house in perfect order. She'd rather clean the kitchen than make love. I'm sick of her, and I feel bad that I want to move on. Actually I am really angry at her, and I'd like to make her pay for how she mistreats me. And how am I going to tell her all of this?

Also, my life seems boring and such a routine. It's the same old thing day after day. The only bright star in my life is Cody. I feel stuck and I know this place. I feel stagnant, compressed and like my energy is stuck in cream cheese. So what are my options? My therapist says "knowledge of options is power." So what are my options?

  • I can tell Anne the truth about these feelings.
  • I can go on the way I have been, stuffing my feelings.
  • I can just move out and find a new place to live.
  • I could suggest counseling for the two of us.
  • I could have an affair.
  • I can talk with my therapist about these feelings.

It's hard to tell Anne the truth that I feel lonely, hurt and depressed, and she'll probably just tell me I need a therapist, like something is wrong with me. I already feel something is wrong with me - sometimes I feel like such a failure. I think it is best to talk to my therapist. Yes, that seems like the best choice, so I'll trust this feeling.

Moving Forward

From his journaling piece, Bill and I were able to recognize that he felt angry and rebellious, but underneath that layer of feeling he felt sad and alone. He realized that he actually felt hurt when Anne didn't want to make love.

I was also able to identify that Bill was struggling with bipolar depression and, at times, agitation. We instituted a weekly exercise plan, and he was better able to move forward. He took up track and surfing, and he soon felt invigorated and better able to handle stress. With his commitment to identifying his thoughts and feelings, Bill was able to get in touch with his feelings, communicate more effectively and gradually work through the pain from his childhood. He expressed rage about how his father treated him, but found that underneath that feeling there was a deep sadness.

Bill later decided he wanted to bring Anne into therapy, and in their third session he mustered up the courage to share his true thoughts and feelings. Understandably he fumbled a bit, but he was generally effective in his communication. He used what is called "I" messages such as "I feel very discouraged about our marriage, I feel angry at you and sometimes I think to myself that I want to leave the marriage."

It's easy to see that this type of messaging told Anne more about what Bill felt rather than what Anne was doing wrong. His communication prompted Anne to share that she felt hurt because of Bill's sarcastic comments. Anne confessed that she distanced herself from Bill as a way of getting back at him. As it turns out, each was trying to get even with the other.

Healthy disagreements and constructive communication were nearly impossible when Anne and Bill couldn't share their true feelings. When Bill was connected to a challenging feeling, his goal was to quickly get rid of it. Anne channeled her anger at Bill with chronic cleaning because she had never learned about assertive behavior from her mom. She needed to make a real effort to express her anger as soon as she became aware of it.

Both Anne and Bill agreed to speak up about what they wanted and to work individually on keeping notes to develop a stronger connection to their thoughts and feelings. Gradually, each partner was able to connect with the full range of feelings, and while it took almost a year, they were able to rekindle their former love and intimacy. Cody is now sixteen, and Bill and Anne have developed a set of skills that will serve them for years to come.

If you are one of the many people who are out of touch with their feelings, there is hope, there is help, and it is just a phone call away.