1. Assertion Aggression Cple - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Conflict, Control, and Out of Control in Couples and Couple Therapy
Chapter 1: ASSERTION AND AGGRESSION IN COUPLES


**Author’s Note: Other than public figures or people identified in the media, all other persons in this book are either composites of individuals the author has worked with and/or have been given different names and had their personal identifying information altered to protect and respect their confidentiality.

Dirk and Madeline were in their early forties.  They have been married for eight years.  They lived together for a couple of years prior to marriage.  They had met when they both were working at a real estate firm.  They said that their relationship had become strained over the past two years.  They were not close as they were before.  They admitted that they were going through a lot of stress.  They were getting into a lot of conflict.  Madeline's had taken a leave from work to give birth and care for the baby for a few months.  The plan was to have her mother care for the baby during the day so Madeline could return to work.  However, grandma got sick and couldn't provide the care.  In fact, she ended up needing Madeline's help to deal with her daily functioning.  So, the short break from work had become a more or less permanent situation.  It was going on four years since the second paycheck came. Georgie was a high-maintenance kid too.  She had been colicky and remained extremely active and moody.  Dirk was the primary- actually the only breadwinner for the family.  However, with the real estate crash, he had gone from a big earner to struggling.  Before the housing market tanked, everyone made money but now it was pretty rough.  A couple of years ago with their financial issues and grandma's medical problems and physical decline, they had moved in with Madeline's mother.

"We don't have much time anymore for doing things as a couple," complained Dirk.  "If there's any open houses or meetings, I have to take them.  I can't be choosy like I could do when houses were selling like pancakes.  Sometimes, I have to be gone for a couple of days or a week.  I've been trying to get into some import export stuff and that's centered in another city.  When I'm home, I'm not around much, and then I'm gone.  Getting back in sync with the household is tough.  And Madeline gets and stays stressed.  There's always appointments or something with her mom or with Georgie.  It's just not the same anymore."  Madeline said, "We have trouble talking.  Our communication is messed up.  If we talk, it's usually Dirk criticizing how I take care of Georgie and my mom.  He doesn't like how the house looks.  It's too messy… it's not neat enough… the food is boring.  He's hardly around so he doesn't really help, but he sure can complain about what I do or don't do.  He gets so mad. Maybe if he was home more or did more when he was, we could have more of a Beaver Cleaver home!"  "See?" Dirk asked the therapist rhetorically.  "That's what I have to deal with.  I work my ass off in this crappy real estate market, and she doesn't give me any credit.  You think I like being gone so much from home?  I'd rather be home… watching soap operas too.  She should know how hard it is out there, but no!  'How come you're late?  Why do you need to be gone so long?  I want this… Georgie needs that!'  It doesn't stop."

Dirk and Madeline had tried couple therapy before: once for about four months and another time for over a year.  In the first therapy experience shortly after the baby was born, the therapist worked with them on improving their communication skills.  They learned to set better boundaries and clarify what each wanted from the other.  They told the therapist, they did a lot of problem solving about setting rules about chores, expectations, and parenting.  It worked well enough so that along with ongoing financial stress they terminated therapy.  After a year, when they were fighting more intensely, they decided to try a different therapist.  Both Dirk and Madeline knew how to "behave" but admitting having trouble following through.  They tired to be more assertive, but that often degenerated into aggression.  Sometimes, it became hurtful.  With the second therapist, they wanted to get to the "core" of their problems.  During this therapy, they learned more about how their respective family experiences and gender role models from their parents were repeated in their relationship.  Dirk said it was all well and good but… "So we figured out both our dads were assholes, but we still fought. Yeah, we… I could see how it was like my or her parents fighting again… but we did it anyway.  Knowing we… I was repeating what my dad did only made me feel guilty and more frustrated."  Madeline also felt the family-of-origin stuff was useful, but said the last couple therapist let Dirk dominate the sessions.  And she had enough of him trying to control her at home.  She did not feel she was heard in therapy… or at home.

In the session, Dirk got visibly angry when Madeline complained about him.  She glanced at him while she spoke to the therapist.  She seemed to pull back from pressing her case… her perspective.  The therapist fed back to Dirk and Madeline that Madeline seemed to hold back when she saw Dirk get upset.  The therapist asked if something like this happened at home.  Dirk started and Madeline confirmed that when they got into an argument, Dirk would get angry and animated.  His face hardened, his voice raised, and his body tensed.  Madeline usually backed off, sometimes physically leaving the room if she could.  Then Dirk would go after her, not just physically but also emotionally.  "Sometimes, I just can't deal with it…" Madeline started to tear up, "and get… I get…emotional."  This made Dirk madder.  He said, "She falls apart and whatever is my issue gets shut down."  "And," Madeline snapped, "he keeps at me.  He won't just give it… give me a break.  It's abusive."  When the therapist asked what Dirk keeping at her meant, Madeline said he kept hectoring her.  When asked how aggressive he was, Madeline and Dirk both said it was mostly verbal and they never really got physical.

This may appear to be a relatively common couple's situation amenable for treatment by a variety of couple therapy approaches.  Communications training could teach more "I" statements and help the partners verbalize overt needs and feelings.  Exploring Dirk's family-of-origin may uncover patriarchal models of control replicating the couple.  Madeline experiences in the family-of-origin may reveal emotional, psychological, physical, and/or sexual abuse that has created hypersensitivity and fears.  There may be significant habits, perspectives, and behaviors creating cross-cultural conflict between the partners.  One or more affairs, substance abuse, depression, anxiety, or processing issues may contribute to the relationship difficulties.  The therapist may decide that Dirk and Madeline both have insecure attachment styles mirroring early attachment deficits.  Narcissism (Dirk) and dependency (Madeline) may become the target of therapy.  Madeline needs to learn how to be more assertive about her feelings and needs.  Family life cycle theories may offer a developmental perspective to the couple who has moved into a new challenging stage raising a young child.

Any, some, and even all of these issues or perspectives may be appropriate foci of couple therapy for Dirk and Madeline.  The therapist may appropriately note that all these issues affect their intensity- specifically, the anger in the relationship.  Their anger is expressed aggressively within the session and at home.  The therapist may direct therapy towards appropriate expression of anger and other feelings.  Madeline has trouble asserting her needs and is tentative in her aggression.  She's more passive-aggressive than overtly aggressive.  "Passive aggressive behavior happens when the person avoids responsibility and attempts to control others to keep them away through his passivity and withdrawal. It is a dynamic born of fear of being controlled, fear of confrontation, hidden anger and an inability to deal straight with people.  Passive aggressive behavior is complex and takes many forms.  We all have passive behavior that comes up when we don't want to deal with conflict directly or do a task.  We all hedge, fudge and remain noncommittal on issues some of the time.  That's normal.  It's only when repeated passivity creates severe issues for others setting up continual tension and anger in the household that it becomes a serious problem that should be addressed" (Namka, 1998).  The therapist should look for behaviors such as:

Saying one thing but meaning the opposite.

Acting passive but aggressively gets his or her own way by not doing what is wanted.

Squelching anger then striking out indirectly (for example, by withdrawing).

Saying "yes" although meaning "no," and then not following through.

Agreement but not complying with agreement, including scheduling appointments but not showing up.

Pattern of "forgetting" things he or she does not like to do.

Partial compliance, missed parts, sloppy execution.

Avoiding asserting oneself, avoiding confrontation, sidestepping responsibility.

Creative avoidance.

Pleasant agreeability, then doing as one pleases.

Procrastination.

Insisting on the other person doing the difficult behavior- avoiding being the "heavy" (for example, disciplining children, confronting problems, etc.).

Not cleaning or cooking or other expected chores or roles.

Refusing to hear criticism, discuss problems, or research such issues.

If Madeline or Dirk is passive-aggressive, the therapist should hold her or him responsible for the aggression and prompt appropriate assertiveness for ones needs.  Problems with asserting oneself may be related to other issues, including abuse.  "CBT with couples proposes a model that violent men have specific difficulties with assertiveness, and have poor communication and dysfunctional thoughts that are strongly linked to the escalation of conflict.  In contrast to this, they describe therapy studies of women who are deemed to have characteristics that make them susceptible to victimization—or being coerced, or to have tendencies that reinforce the man's violence" (d'Ardenne and Balakrishna, 2001, page 241).  Dirk apparently does not need any assertiveness training from a lay definition.  However, his aggressive tone and style may be over-compensation for difficulties being appropriately assertive.  He needs to learn how to be assertive while balancing how to be more conciliatory and receptive to Madeline's feelings.  Dirk's process may bear closer examination.  It would not be unexpected that his aggression is both covert- passive-aggressive and overt.  The therapist presents many of these issues as goals of therapy and Dirk and Madeline both agree.  Throughout the course of therapy, the therapist intuitively and conceptually recognizes a relationship among emotions, anger, assertiveness, and aggression.  Dirk and Madeline have dysfunctional dynamics with these issues.

The therapist must continually assess and work on the distinctions among anger, assertive anger, aggressive anger, and spiritual, emotional, intellectual, and psychological aggression.  And, stay alert to boundary lines crossed from assertion to aggression to abuse.  All abuse: emotional and psychological, mental, physical, or sexual is emotional and psychological abuse.  "Psychological abuse (verbal and nonverbal) has been shown to coexist with physical abuse among married couples, during courtship, and during pregnancy.  Psychological aggression is an antecedent to physical aggression and known to be associated longitudinally.  Husbands' physical assault and SA (sexual abuse), including rape, are consistently related, especially among battered women.  More women experience both physical and SA whereas a much smaller proportion experience sexual violence in the absence of physical violence. Information on female SA towards their husbands is sparse" (Ramisetty-Mikler et al., 2007, page 32).

Dirk and Madeline need work on their anger issues, being appropriately assertive or aggressive.  And the therapist needs to keep assessing the couple.  How angry is each partner?  How is the anger expressed in the relationship?  How does each partner assert him or herself?  How does each partner aggress?  Does either partner go step across the boundary of abuse?  When there is emotional or psychological abuse, does… why… and how does it become domestic violence?  If the aggression in the relationship was "mostly verbal" and "never really got physical," what did that mean about when the aggression was more than verbal?  And if the aggression "never really got physical" what was as is implied did occur when it "sorta got physical?"  Staying in control means being mindful when crossing from assertiveness to aggression, and most of all not crossing the boundary from aggression to abuse.  Dirk and Madeline's vague comments leaves uncertain if they get out of control in their conflicts.  The couple therapy may go on for a few weeks, a few months, and even years without addressing their pattern of conflict.  This occurs if the therapist does not follow up on client denials, minimizing, or diversions.  And fail as prior couple therapy had failed if the therapist does not identify the scope and depth of aggression, especially abuse.  Dirk and Madeline's core issues may revolve around emotional and psychological aggression and abuse.  Their issues may be founded onto deeply embedded characterological issues including personality disorders.  Their aggression and abuse may be entirely verbal, or they may cross over to physical confrontations and conflicts constituting domestic violence.  In all cases, there remain key shared therapeutic principles and strategies appropriate for the therapist to consider, as well as key distinctions.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
(510) 614-5641 or (510) 582-5788
fax: (510) 889-6553
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