Q: My wife and I met in law school and, as I launched a solo
practice, she worked for a nonprofit until the first of our two
young children was born. In the courtship stage, I was very
attracted by a kind of excitement and unpredictability that she
exuded. But since we have been trying to run a family together, her
moodiness, flashes of anger (as well as much more welcome humor),
and huge, dramatic reactions to so many things that happen in the
course of day-to-day life have been hard to take. On those
occasions when she is confronted (by me or occasionally a friend),
she alternates between rage and tears, and at one point took a
large bunch of pills that could have done her real harm. She did
start therapy and initially thought her therapist walked on water,
but now sees him as useless, and her constant emotional ups and
downs have not stopped. Her doctor has prescribed antidepressants,
which certainly helped a bit, but not enough. So many of my work
days are disrupted by phone calls from her, or just by my
distracting worries about how she is doing while looking after the
kids. Recently, her therapist said he'd like to refer her to a
"DBT" group. Is that a good thing? Is it likely to make a
difference?
A: DBT is dialectical behavior therapy, a treatment approach
developed by psychologist Marsha Linehan in the 1970s that has
gained wide acceptance in the past couple of decades. It combines
cognitive behavioral and Buddhist-influenced elements into a
package that often combines individual and group therapy in a way
that has been particularly useful to individuals who experience
intense floods of emotion that may contribute to destructive
behavior and unstable relationships. Over time, participants learn,
for example, to better accept unpleasant realities, tolerate
distress, solve interpersonal problems, and to soothe and encourage
themselves. These and other elements are taught (largely in
class-like groups that include homework) as learnable
skills. There is good research to back up reports of treatment
success using DBT -- of course, no treatment is a panacea, and this
approach requires active effort.
The DBT therapist recognizes that people with a tumultuous
mood/personality style did not choose it and are not seeking to
make life difficult --their behavior reflects their internal
reality. But the therapist also makes it clear that many of these
behaviors are maladaptive and requires collaboration from the
patient with a joint mission to develop more workable and rewarding
ways to cope.
It sounds as if your wife's therapist is already aware of DBT
resources in the area. If you would like to consult further about
your role and stance as family life moves forward, feel free to
arrange a (free, confidential) consultation at LCL.
Questions quoted are either actual letters/e-mails or
paraphrased and disguised concerns expressed by individuals seeking
assistance from Lawyers Concerned for Lawyers. Questions for LCL
may be mailed to LCL, 31 Milk St., Suite 810, Boston, MA 02109 or called in to (617) 482-9600. LCL's licensed
clinicians will respond in confidence. Visit LCL online here.