Distracted from legal work by spouse's emotional roller coaster

Issue March 2013

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.

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