February 18, 2011

The Importance of Men Accepting Influence in a Heterosexual Marriage

Posted by Nathen under divorce, gender, John Gottman, statistics
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John Gottman’s research show evidence that one of the most important things in making a heterosexual relationship is that the male “accept influence” from the female. That is, the male listens to and is influenced by the ideas and opinions of the female. He shares power with her. If he does not do this, they will end up divorced 80% of the time.

One of the reasons Gottman is such a famous couples researcher is that he finds effects that strong. Your average couples researcher would love to find something that predicted anything about a couple’s future with 30% accuracy, but Gottman’s work is rife with 80% and up findings. 80% is huge. At 80%, you’ve left the realm of “more likely” behind and have solidly entered “probably.” If you are a man who has trouble conceding a point to your wife, you should take note. You will probably be much better off if you spend your energy scouring your conversations for ways to agree with your  wife than ways to disagree. If that is difficult, get some help with it.

And it does not go the other way. Gottman found that while wives tend to be good at accepting influence, whether they are or not did not correlate with anything he measured.

Which, of course, brings up the question of same-sex relationships. How does accepting influence influence things there? The answer, as is usually the case in couples research, is that we have no idea, which hip researchers are often apologizing for but rarely doing anything about. My advice is to notice and accept influence regardless of your gender or sexual orientation–better to lose arguments than  your relationship.

 

February 12, 2011

Gottman’s Influenced Stable Steady State, Negative Affect Reciprocity, and Repair

Posted by Nathen under Couples and Family Therapy, emotions, John Gottman, relationships
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John Gottman says, in his book The Marriage Clinic, that there are basically two things that make the difference between couples who stay together and those who do not. First is what he calls the partners’ “uninfluenced stable steady states,” which are a result of the temperament of each partner plus the history of the relationship.  The second is the partners’ “influenced stable steady state,” which is the emotional direction that each partner takes, once they are interacting.

If the way you feel and act worsens when interacting with your partner–that is, if your influenced steady state is more negative than your uninfluenced steady state–you may well be heading for a divorce. The crucial question is, how much negativity from your partner does it take to turn your mood negative? If you can respond in a positive way to your partner, regardless of their mood or complaint, that’s a real strength. If you respond in a negative way, this is trouble. Negativity will tend to escalate in each conversation and throughout your relationship. Gottman says that if you cannot maintain a ratio of 5 to 1 positive-to-negative interactions at worst (that is, during conflict) you are heading towards (or are in) an unhappy relationship. If you dip below a 1 to 1 ratio, you are heading toward divorce.

“Negative affect reciprocity” is a closely-related pattern that Gottman says is the best predictor of happy or unhappy couples. (“Affect,” remember, is just a science-y word for emotion.) The extent to which you are more likely than usual to be negative when your partner is negative (as opposed to when your partner is neutral or positive), you are showing negative affect reciprocity. This could look a lot of ways, like responding to anger with your own anger, responding to criticism with stonewalling or defensiveness, responding to sadness with irritation, and so on.

Gottman says that negative interactions are inevitable, so what he calls “successful repair attempts” are all-important. That is, emotional repairs such as humor, taking responsibility, compromise, and soothing, must be offered, recognized, and accepted. When couples can recognize and accept all of each other’s repair attempts, he says, they are finished with therapy.

 

January 30, 2011

90 By 30

Posted by Nathen under 90 by 30, child abuse, child maltreatment, child neglect, children, domestic violence, DSM-IV-TR, endorsements, mental disorders, Trauma Healing Project, UO Men's Center | Tags: |
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One of the heads of my Couples & Family Therapy program, Jeff Todahl, is launching an exciting and inspiring campaign this coming Saturday. It’s called “90 by 30,” referring to his intention to reduce domestic violence and child maltreatment by 90% by the year 2030 in Eugene and Springfield.  He announced the launch at a domestic violence awareness event I helped put on with the University of Oregon Men’s Center last fall. [Here’s the video of his talk. It’s good.] As an expert on domestic violence and part of the Trauma Healing Project in Eugene, he has decided:

1) We know how to do it–all of the programs necessary have been invented and proven effective in various parts of the US.

2) It is feasible to bring all of those programs into one area and virtually eliminate domestic violence and child maltreatment here.

3) Doing so will be a huge step toward the elimination of domestic violence and child maltreatment nationally and globally.

4) The elimination of domestic violence and child maltreatment would shrink the 943-page Diagnostic and Statistical Manual of Mental Disorders to the size of a pamphlet. That is, it would mean a virtual elimination of mental health problems for humans.

If you are in Lane County and this sounds like an interesting project, join us for a panel presentation by Jeff and his collaborators February 5th, 2011, from 11am – 2pm at the University of Oregon. The event will be held in Room 220, HEDCO building, at 17th and Alder, Eugene, Oregon.

 

January 29, 2011

Diagnostic Criteria for Sleep Terror Disorder

Posted by Nathen under benzodiazepines, diagnostic criteria, DSM-IV-TR, fear, lists, sleep, Sleep Terror Disorder
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We don’t really know but the DSM estimates between 1 and 6% of children and many fewer adults have this experience. You are more likely to have this happen if you are related to someone who has had this happen, but we have no idea why. It usually just goes away in adolescence. If my parents had been the type to take their kids to mental health professionals, I almost certainly would have gotten this diagnosis as a kid. If so, and if my parents had been the drug-giving kind, I might have been prescribed a benzodiazepine (like Valium) for it. Generally, though, it can be treated by comforting your child when they wake up like this, until it goes away. If you think there might have been a triggering event for the condition, therapy might be helpful.

Here are the criteria, quoted word-for-word from the Diagnostic and Statistical Manual of Mental Disorders IV-TR, page 639:

Diagnostic criteria for 307.46 Sleep Terror Disorder

A. Recurrent episodes of abrupt awakening from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream.

B. Intense fear and signs of autonomic arousal, such as tachycardia, rapid breathing, and sweating, during each episode.

C. Relative unresponsiveness to efforts of others to comfort the person during the episode.

D. No detailed dream is recalled and there is amnesia for the episode.

E. The episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

F. The disturbance is not due to  the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

 

 

January 24, 2011

Two Spaces After a Period Is Wrong

Posted by Nathen under American Psychological Association, APA Publication Manual 6th Edition, Reanna
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In case you’re not up to date on the current American Psychological Association guidelines, they decided in their recent let’s-hit-the-college-kids-up-for-more-money new edition of their style guide (Don’t buy it, by the way. Go here instead.) that we now have to put two instead of one space after each period.

That’s why this email I got from Reanna is funny:

The two spaces after a period convention came about in reaction to the monospace fonts of typewriters (they’re so gappy that the extra space helped to differentiate the end of the sentence). Now all the fonts we use are proportional (except courier), and typesetters agree that two spaces is wrong.
“We would never accept teachers pushing other outmoded ideas on kids because that’s what was popular back when they were in school. The same should go for typing. So, kids, if your teachers force you to use two spaces, send them a link to this article. Use this as your subject line: “If you type two spaces after a period, you’re doing it wrong.”


Somebody tell the APA.
 

January 21, 2011

The Definition of Disease

Posted by Nathen under ADHD, alcohol abuse, American Medical Association, Anorexia Nervosa, Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, death, diagnostic criteria, disease, DSM-IV-TR, lists, mental disorders, suicidality
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I attended a lecture today about addiction where the lecturer claimed that the American Medical Association requires that a phenomenon meet the following criteria to be considered a disease:

1) It must be progressive

2) It must manifest identifiable symptoms

3) It must occur chronically in affected individuals

4) It must be fatal if left untreated

That makes some things obvious diseases. Cancers, for example. There are many things that we consider diseases that do not fit these criteria, though. I believe that obesity, for example, is not officially considered a disease because it is not fatal. It’s correlated with many fatal conditions but isn’t fatal on its own. Most mental disorders fail to meet this criteria too. Anorexia is fatal if untreated, but anxiety disorders, dissociative disorders, ADHD, learning disorders, conduct disorders, psychotic disorders, and dissociative disorders and many others are not. There is a pretty good case to make for  alcoholism and some other addictions meeting these criteria. Disorders that are associated with suicidality, too, might qualify, like severe depression, and possibly “gender identity disorder,” though GID may not be progressive and so fail the first criteria.

 

January 17, 2011

Two Models for Relationship Development

Posted by Nathen under development, integration, intimacy, metaframeworks, recursion, relationships
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Last term I read Metaframeworks, a book about Bruenlin, Schwartz, and Kune-Karrer’s integration of family therapy models. It’s a fun read, but don’t run out and buy it unless you are like me, very nerdy about family therapy and a sucker for good theoretical integrations.

Metaframeworks presents two models for how relationships can grow over time. The first is a model from the 80s, by a family theorist named Wynne. In it, people in relationships develop four capacities, in this sequence:

1) Attachment/cargiving: We have “affectional bonding” with each other.

2) Communicating: We have “communicational codes” in common.

3) Joint problem solving: We have the ability to work successfully together on complex tasks.

4) Mutuality: We have the ability to renegotiate the relationship.

Metaframeworks criticizes Wynne’s model as “epigenetic,” meaning that each stage is related to the next in the way that our genes are related to our bodies: Each stage is the source and foundation of the next. If their analysis of Wynne is correct, then Wynne thought that you can’t really communicate in a relationship until you have achieved “affectional bonding.”

The authors’ scheme is similar but more complex. It has six processes that happen in relationships, and the relationships between them are “recursive,” meaning the product of each process affects the other processes. They are ambiguous about the sense in which their processes are a developmental scheme. My best guess is that they mean that each of these processes can develop in relationships, and the better developed they are, the better off we are. They say a few things that hint at a stage model, that each stage flows from the previous, and that inadequate development of an earlier process constrains later ones. But they don’t use words like “earlier” or “later” and they are very clear that the processes are related in a web-like fashion. Very postmodern. Anyway, here are the processes:

1) Attraction: We feel drawn together.

2) Liking: We appreciate and value each other.

3) Nurturing: We create safety by exchanging care.

4) Coordinating meaning: We can agree on what it means when we do and say things.

5) Setting rules: The rules by which we operate are functional.

6) Metarules: We have ways of changing our rules when we need to.

It is interesting that both Wynne and Metaframeworks consider and then reject intimacy (where “each person comes to believe in and experience the relationship as completely safe”) as a highest stage or most complex process. Wynne, apparently, does so because it is “difficult to achieve.” Metaframeworks does so because that trust can be lost, and because some couples with functional relationships never get there.

I’m not convinced. I really value intimacy in my own relationships, and I think that if we stop short of intimacy, at “stable and successful,” in our close relationships, we are missing out. And why reject a developmental stage because it is difficult to achieve?

 

January 14, 2011

Economists, 1998, 2010

Posted by Nathen under economics, quotes
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Heard said by an economist on NPR in 1998: “What I’m saying is this: What goes up must… pause before going up again.”

Heard said by an economist on NPR in 2010: “As they say on Wall Street: Flat is the new up.”

 

January 10, 2011

Six Easy Ways to Turn a Complaint Into a Criticism

Posted by Nathen under complaints, Couples and Family Therapy, criticism, four horsemen of the apocalypse, John Gottman
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It is very important to be able to complain in your relationship. The sooner the better, in most cases, before it festers. There are more and less skillful ways to bring a complaint, of course, but do the best you can. If your complaint crosses the line into criticism, though, you are doing something that, according to John Gottman, is toxic to your relationship. Criticism is one of his “Four Horsemen of the Apocalypse” for relationships. Everyone does it, but the less the better, and some kind of repair is in order when you do.

Criticism is a negative, global statement, often about someone’s character or history. It brings out defensiveness (another of the Four Horsemen) because it is an attack. Any complaint can easily be turned into a criticism. Here are some of Gottman’s observations about how we do it:

Start a complaint with “You always…”

Start a complaint with “You never…”

Start a complaint with “The problem with you is…”

After a complaint, ask “How can you treat me this way?”

After a complaint, ask “Why would you do a thing like that?”

After a complaint, ask “What is wrong with you?”

 

January 9, 2011

An Outline of Carl Whitaker’s The Roots of Psychotherapy

Posted by Nathen under books, Carl Whitaker, Couples and Family Therapy, existential therapy, experiential family therapy, Open Office, Person Centered Therapy, psychiatry, psychoanalysis, reading
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I started reading Whitaker and Malone’s 1953 The Roots of Psychotherapy last summer, on the advice of John Miller, one of the heads of my Couples and Family Therapy program. He hadn’t actually read it, but had had it so highly recommended to him by a respected colleague that John wished he had time to read it. It was a difficult read, especially in addition to my regular course-reading, but interesting to see what looked like Whitaker’s explanation of his transition from psychiatry and psychoanalysis to the experiential family therapy of his later career.  You can see elements of existential, experiential, and person-centered therapies emerging in Whitaker, all explained in Freudian language.

My outline is quite sloppy, thanks mostly to Open Office’s awful outlining capabilities, to inserting my own comments, and to my own lack of understanding at times, but the guts of the book as I did understand it are here. I don’t recommend reading it unless you are a therapy nerd, but if you are, and especially if you are interested in Carl Whitaker’s model of therapy and its origins, I do recommend it. In less than an hour you can get the basics and decide if the book is worth reading for you.

 

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