7 ways your depressed husband shows up in couples therapy
Wednesday, May 8, 2024.
We have been studying men like your depressed husband in couples therapy for more than twenty years…
Many researchers now believe that these husbands act out in couples therapy in one of two problematic ways:
They Use Emotional Camouflage. The “Guy Code” and “Normative Male Alexithymia” require your depressed husband to embrace the norms of stoic endurance, quiet self-possession, mental toughness, and self-reliance (Pollack, 1999).
If they are in full-on camo, depressed husbands will show up as irritable, withdrawn, self-medicated, and/or somewhat pissed-off.
They feel ashamed, incompetent, and fear failure. Perhaps the biggest issue in working with your depressed husband in couples therapy is that all-purpose therapists tend to sell the depressed husband short.
While it’s true that some depressed husbands avoid discussing the quality of their intimacy with their partner, it’s often because they feel uncomfortable and unsure of themselves (Shepherd, 2005).
The natural antagonism between your depressed husband and your couples therapist
Here is an interesting idea. Could it be possible that your depressed husband and your couples therapist, (regardless of gender) are naturally at odds with one another?
You can always spot a bad couples therapist by the speed and certainty in which they clearly identify the depressed husband as the problem.
Here are 4 ways your depressed husband may act out… and wind up in couples therapy:
They usually have a much more difficult time containing their anger and tend to stonewall when flooded by what they may perceive as nagging.(Gottman, 1999).
Men lead women (although women are rapidly catching up) in the role of being unfaithful (Peluso, 2007).
Often, they have far more difficulty identifying and talking about vulnerable emotions (Levant, 1995) and (Wexler, 2007).
Also, men are more likely to be chronically emotionally unavailable, ambivalent, and even resistant to the couples therapy process (Englar-Carlson & Shepard, 2005).
Couples therapists, both skilled and unskilled, male or female, share a natural affinity with wives. Like the wives, they believe it’s a good idea to talk about feelings. They want him to ask for help and express vulnerability. Your depressed husband’s resistance to these values is where the skill of a highly trained science-based couples therapist is put to the test.
How your husband can be supported in couples therapy
The challenge in working with your depressed husband in couples therapy is that it may take more energy for the therapist to establish a strong bond with him.
But the couples therapist can’t focus too intently on the depressed husband that they alienate his perhaps long-suffering wife.
Evoking vulnerable emotions from your depressed husband is the key.
With the stoic denial of feelings, intellectualizing & defensive reactions, your depressed husband requires more direct attention in the first few hours of the first day of the couples therapy intensive.
Two research studies have shown that the quality of the therapeutic bond between the depressed husband and the couples therapist is utterly paramount. The quality of this bond was oddly more predictive of outcome than the quality of the bond with his wife (Bourgeois, Sabourin, & Wright, 1990) and (Symonds & Horvath, 2004).
It’s essential to try to balance attention with both partners, but depressed husbands might need a little extra attention early on to get them onboard (Garfield, 2004).
Research shows that an essential measure of success in couples therapy is how well and how quickly your therapist can emotionally connect with your depressed husband. Be patient. It’s worth it.
7 challenging ways a depressed husband shows up in couples therapy:
Men often complain about being “ganged-up on” in couples therapy (Englar-Carlson & Shepard, 2005).
They may exhibit “tells,” which suggests an inner feeling of Shame. Men may avoid eye-contact, look down, or turn away from their partner during a conversation during couples therapy.
They may show up as a “prickly pear,” reacting sharply to even mild criticism.
Men sometimes make either sarcastic or sincere self-critical comments in therapy.
They sometimes display a cynical, fatalistic, and pessimistic outlook.
Your husband may, at first, actively resist any attempt by your couples therapist to facilitate a meaningful dialogue with you.
He may Become furious instead of curious, and complain about being the “designated problem.”
How to introduce the elephant in the room to the depressed husband and his spouse
How do you draw attention to a husband and his spouse to the notion that he is, well…depressed?
This is fraught with peril. If we go right at it, your partner may hear us as just saying he is, once again, the “designated problem.”
We may also run the risk of over-focusing on his perceived deficits. This might erode any progress we have earned is building a therapeutic bond with him.
Clinical skill is essential. We must encourage a mutual curiosity in both partners but in a tentative and humble way.
The ultimate goal is to get the husband and his wife talking about his inner experience. This invites empathy and insight into the therapy process.
It’s also helpful for the couples therapist to offer the observation that the depression is an aggravating factor, but the depressed husband is not solely the problem.
A good couples therapist will be capable of initiating and sustaining a dialogue with your husband about his feelings. But a great couples therapist will be able to start, maintain, and hand-off that conversation to your depressed husband and you. In Emotionally-Focused Couples Therapy, this is called an “enactment.”
The goal is to create a safe place for you both to discuss the Elephant in the Room without your husband feeling blamed or shamed.
Your couples therapist has several tools in the toolbox to accomplish this...
First, they go slow. They listen carefully for metaphor, feeling words, and not-so feeling words at first (Rabinowitz & Cochran, 2002). Going too fast into feeling is a common rookie mistake with a depressed husband just entering couples therapy.
How an excellent couples therapist will engage with your depressed husband…
For example, it ‘s probably futile to ask a depressed husband, “how do you feel about that?” But “what’s it look like from your side of the street?” may go down a lot easier.
We know that your husband will admit (perhaps grudgingly at first) that talking about his marriage is extremely difficult, but necessary and unavoidable part of the process (Rabinowitz & Cochran, 2002).
But it’s a common blunder for the couples therapist to slather on the empathy too thickly at first.
All-purpose therapists may mean well, but chestnuts like “It takes a lot of courage even come here…” or “I admire you for having the strength to reach out…” tend to reinforce instead of relieving the very shame he’s feeling just sitting there in couples therapy (Osherson & Krugman, 1990).
A better move is to say something like, “What’s it like for you to be here right now? Or “It’s pretty typical to feel a little uneasy about what we’re going to do here…I was just wondering if that describes it for you right now?”
Feeling defeated just for being in couples therapy…
An excellent couples therapist will know that your husband probably already feels a little defeated just being in couples therapy.
This isn’t necessarily a problem. It provides an opportunity to discuss what’s real for him right now.
Another thing. EFT reminds us of the importance of metaphor. Normative Male Alexithymia blocks access to feelings, but a powerful metaphor can free up the inner log jam of emotions (Shay & Maltas, 1998).
The skillful use of metaphor is an essential tool in the science-based model of Emotionally-Focused Couples Therapy. But the flip side of that skill is to also be able to detect where metaphor must be subordinated in a clinical discourse when one of the partners is neurodiverse.
A good couples therapist will also normalize ambivalent feelings by modeling self-disclosure. The twin tools of using the client’s metaphors (or offering some that might seem appropriate), and skillfully self-disclosing are a sign that you and your depressed husband are with a competent, evidence-based couples therapist.
Talking about the “guy code” with your husband…
It’s important to talk about what your depressed husband does with feelings, and not buy into the notion that he doesn’t have any.
Perhaps it would be also useful for him to explore his historical relationship to grief and sadness, and how his relationship with you shapes his inner emotional world.
Depressed husbands in couples therapy can be tough. They are often reluctant, if not resentful, clients. And they may need more TLC than their wives early on. An excellent science-based couples therapist will have a rich understanding of the “guy code” and will be able to discuss socialization with empathy.
A good couples therapist will also not be triggered by resistance and will be open and free of judgment. These men need patience, empathy, and humility from their therapist.
Working with depression is a fundamental skill in couples therapy. About 7% of Americans are clinically depressed, but over 40% of couples who present for couples therapy have at least one depressed partner.
The importance of empathy…
But understanding the nature of a depressed husband and engaging with him quickly and empathetically is a crucial skill for a couples therapist.
But this empathy must be presented skillfully and not in a gushy or squishy way.
Many poorly trained couples therapists bristle at the notion of gender politics in the therapy room.
That’s a mistake. Sure, a depressed husband can be difficult, but that doesn’t necessarily identify him as the singular, designated problem.
Depression is an overwhelming challenge in modern marriages. Over half of all depressed husbands report having marital conflicts. And we also know that depressive episodes are often the threshold events that precede incidents of bickering and fighting.
Gottman tells us that when all the four horsemen (criticism, defensiveness, contempt, and stonewalling) show up, and the depressed husband is unwilling to accept influence from his wife, the likelihood of divorce is 93%.
Final thoughts…
Depression is a frequent factor in couples therapy, which is why a careful assessment is so essential. But a hallmark of an uninspired therapist is too overuse empathy, and have tunnel vision which suggests that he is seen by both of you as the “designated problem.”
Therapists can start by having a more curious, detached, and inquisitive stance toward depressed husbands.
“Gee…how did that sit with you?” is better than “I imagine that made you feel…” Empathy can fail sometimes when it speculates.
Be well, stay kind, and Godspeed.
…Because depression may only be part of the problem
RESEARCH:
Johnson & Jacob (2000) and Benazon & Coyne (2000) confirm Gottman’s Data. Depression is a massive problem in couples therapy, and the depressed husband typically requires careful handling from the start.
