3. Evaluation & Assessment - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Born that Way, Temperamental Challenges in Relationships and Therapy
Chapter 3: EVALUATION & ASSESSMENT
by Ronald Mah





Assessment may be informal within the therapy while some therapists may choose to use a formal structured assessment tool.  Tests for individual traits and individual personality may be useful for looking at couples.  Hjemboe and Butcher (1991) studied a widely known and utilized test for individual assessment of personality, the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) for use with a marital population.  It measures personality characteristics and marital distress and provides empirical validation.  It found that the Psychopathic Deviate (Pd) clinical scale and Family Problems (FAM) content scale were relevant indicators of marital distress (page 234).  Individuality is another personality trait that has been seen as likely to affect couple's dynamics, including through women's work lives (Helson and Roberts, 1992).  As indicators of marital distress however, it is not clear what causal relationships may exist.  For example, women's individuality has been hypothesized to affect marital relationships.  Individuality could include originality, creativity, and openness to ideas, impulses, and change as opposed to conventionality and constrictedness.  Yet, individuality could also indicate maximizing personal benefit as opposed to cooperation, altruism, and other values (page 577).  The limitations of identifying a specific trait as relevant are two-fold.  First, is that it implies a causal effect and does not examine other dynamics that interact to make it potentially relevant.  And, since for example individuality can be selfish or it can imply independent and autonomous or both, the meaning of the trait can itself be in question.  Individuality especially for women in more traditional gender role couples would imply greater potential for conflict.  However, a less traditional partner who respects and enjoys, that is not being threatened or uncomfortable the individuality of the female partner may find it adding to marital content.

Boen (1988) discussed several formal marital assessment tools in his article "A Practitioner Looks at Assessment in Marital Counseling."  Boen briefly introduced five tools: Stuart's Couples Precounseling Inventory, Russell and Madsen's Marriage Counseling Report, Taylor-Johnson Temperament Analysis, Snyder's Marital Satisfaction Inventory, and Spanier's Dyadic Adjustment Scale.  Each of the tools requires extensive scoring either by the therapist's computer, online, or mail-in for computer analysis and a report, except for the Taylor-Johnson Temperament Analysis.  Boen recommends using such tools not just for assessment but also a part of treatment.  "The clients and I proceed to use the results of the instrument to focus on specific areas that need to be addressed in the marital situation.  We may refer to the instrument as needed in the future sessions, either using it continuously for couples who wish to do so, or referring to it periodically for couples who use it as a springboard into other areas of discussion" (page 484).  These and similar tests often look at how well matched partners may be.  There have been many studies that support the idea that people will sort themselves by those who are similar to themselves in various ways: "age, ethnicity, religious background, height, weight, socioeconomic status, values, political orientation, and even nose breadth and earlobe length."  However with regard to personality characteristics, evidence seems to support match according to the partners being extraverted and neurotic (Botwin, et al., 1997, page 108).  Not everyone agrees in more recent studies according to Watson et al. (2000) who asserts that levels of extraversion as a predictor of marital instability has mixed results (page 416).  The focus on these traits comes from "… the prominent five-factor or "Big Five" model of personality.  This model developed out of a series of attempts to understand the natural language of trait descriptors (see Block, 1995; Digman, 1990; Goldber, 1993; John, 1990).  Extensive structural analysis of these descriptors consistently revealed fiver broad factors: Neuroticism (vs. Emotional Stability), Extraversion, Conscientiousness, Agreeableness, and Openness to Experience (or Imagination, Intellect, or Culture)… As early as 1935, Terman and Buttenweiser observed, 'One would hardly expect a man and woman both highly neurotic, to achieve a very high order of marital happiness' (p. 135).  This prescient observation has been extensively corroborated by subsequent research" (Watson, et al., 2000, page 415).

Common sense rather than prescient abilities, much less a need to seek confirmation through extensive research would predict that partners who are both fairly neurotic would probably have significant problems as a couple.  By the same token, it is not surprising to find "consistent evidence that active, cheerful, and enthusiastic individuals (i.e., those high in positive affectivity) tend to report close and satisfying relationships" (Watson, et al., 2000, page 436).  Blum and Mehrabian (1999) replicate this assertion but make a significant extension to it.  "…individuals who have a greater emotional predisposition toward pleasant, rather than unpleasant, emotional states, are more likely to be satisfied in their marriages, irrespective of the temperament characteristics of their mates.  Also, those who have a greater emotional predisposition to feel in control of their relationships and life circumstances, instead of feeling controlled and guide by others and/or external events, are more likely to feel satisfied in their marriages" (page 113).  One needs not to be an experienced therapist to know that unhappy neurotic individuals and couples come much more often to therapy, and that not a whole lot of relationships made up of pairs of happy "active, cheerful, and enthusiastic" individuals come to therapy.  However, what makes the predisposition to pleasant emotional states so powerful that coupling tends to result in satisfaction irrespective of partner's other temperamental traits?  Are the pleasant emotions an affective narcotic making negative or difficult partner temperament tolerable?  Or, perhaps the pleasant emotional predisposition and the accompanying sense of control in their relationship and life enable an individual to be able to manage the challenges of the difficult partner or child's temperament and behavior?  What causes the neuroses and what facilitates and supports the positive and/or pleasantly emotionally predisposed individuals is in question.  Each individual and each partnering has the potential to greater or lesser happiness or functionality and greater or lesser problems and dysfunctionality.  Each individual may not be so much predisposed but had developed positive or pleasant emotional attitudes.  Although identification of key traits can be informative, the complexity of personality requires more in depth evaluation of its development.  

Buss (1991) presented a framework that "…consists of three mechanisms by which features of persons interact with features of the environment: selection, evocation, and manipulation.  Selection involves nonrandom entry into, or avoidance of, certain environments.  Evocation is defined by the ways in which persons unintentionally elicit responses from others occupying their environments.  Manipulation deals with the tactics intentionally deployed to alter or influence others in environments that have been selected" (Buss, 1991, page 665).  An individual interacts with many people, situations, and circumstances.  Some of these are random and outside of individual's control.  Climatic, global, historical events and trends, and activities and actions by other people can randomly affect an individual and his or her development.  However, the ways that an individual is nonrandomly exposed to selected environments and the mechanisms for creating the nonrandom exposure are key to development.  Buss found that selection and evocation as two core interactional mechanisms.  "Mates with certain personality characteristics will perform and elicit actions that evoke upset in their partners.  The selection of mates with certain personality characteristics therefore produces predictable forms of evocation.  Selection and evocation are causally connected over time" (page 684).  Aliya selected first Charlie's father and then Samuel to be her partner.  She selected two men with similar personalities.  Prior to seeking and finding mates, an individual had practiced selection of play partners and other relationships, evocation of other persons' feelings and thoughts, and manipulation of others in the environments of the family-of-origin, daycare, school, and other communities and social groupings.  The interactional processes begin immediately with the newborn's cries and immediately although unintentionally evoke responses from caregivers.  With experience and practice the baby is more selective and purposeful evoking and manipulating the environment and its inhabitants.  

The baby starts with whatever he or she is born with temperamentally.  "An individual's interaction with his or her caregivers and the greater environment may be significantly influenced by his or her temperament.  Temperament is considered to precede nurturing and socialization influences… Criteria of heritability, stability into adulthood, and appearance to age two yielded three dimensions: emotionality, activity, and sociability (Buss & Plomin, 1984).  Novelty or sensation seeking also meets the criteria of temperament: temporal stability, early appearance, and biological basis (e.g., Fulker, Eysenck, & Zuckerman, 1980; Hur & Bouchard, 1997" (Teglasi et al., 2004, page 10).  Heredity or the biological origin of temperament type shows in functional M.R.I. scans which looks at brain activity and in structural M.R.I. scans which examines brain anatomy.  "In 2007 Carl Schwartz, the Harvard psychiatrist who has taken over the follow-up work on Kagan's two longitudinal studies, put 76 of Kagan's study subjects in an M.R.I. machine.  At the time, they were 18 years old. (Baby 19 was part of the sample… He found that the subjects who were high-reactors at 4 months tended to show significant thickening in the prefrontal cortex compared to those who were low-reactors.  'This was amazing,' Schwartz told me.  'The temperament they exhibited as infants still seemed to leave a fingerprint in the brain 18 years later.'  He is still trying to work out the exact meaning of this fingerprint; he cannot yet tell, for instance, whether a thicker cortex is a cause of a high-reactive temperament, or an effect, or something else entirely.  One job of the prefrontal cortex is inhibitory, putting a damper on signals that come from the amygdala.  Could it be that the cortex thickens more in the anxiety-prone as it is busy tamping down the overactive amygdala and growing new neural connections?  Or does a thicker cortex come first, and contribute to a tendency to be anxious in the first place?" (Henig, 2009).

Temperament is a stable biological dimension observable in young babies, which leads to speculation regarding the underlying mechanisms.  Speculation on the origin of differences include physiological models that relate neurobiological mechanisms to temperament focus on "individual differences in sensitivity to the types of stimuli that draw attention or create stress (such novelty or riskiness, social or nonsocial, and signaling reward or threat).  Gray (1982, 1987) proposed that temperamental individuality is based on the balance between two biologically rooted motivational systems, the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS).  The BAS responds to signals of potential reward and nonpunishment (hope and relief), whereas the BIS responds to signals of punishment and nonreward (fear and frustration).  The BAS activates approach behavior, increases arousal, and directs attention to positive cues.  The BIS, on the other hand, prompts withdrawal from aversive stimuli or inhibits behavior, increases arousal, and directs attention towards negative cues.  Research has supported the differentiation between reactivity to positive and negative affective cues (Larsen, 1991); Rusting & Larsen, 1995; Watson & Clark, 1991), as well as the differential associations of the BIS and the BAS arousal systems, respectively, with attention to cues that signal threat or reward (Derryberry & Tucker, 1991)" (Teglasi et al., 2004, page 10).

The M.R.I. observations and speculation about their meanings and speculation about the roles of the BIS and BAS systems are reflected in observations of behavioral correlations in individuals.  Certain temperamental traits or profiles of traits are highly correlated with immature defense mechanisms.  There is significant influence by numerous variables in the environment that affect the defense mechanisms, which ideally developmentally lead to more mature defenses.  While the early defense mechanisms are more innate, the later more mature defenses are not as highly related to biological measures.  This development is biology influenced and altered by the infant or child's larger worlds.  "This process may occur as a result of the gradual process of learning, as suggested by Vaillant, or in some cases as a result of being 'imprinted' following a specific traumatic experience" (Shaw et al., 1996, page 111).  As a result, two individuals with highly similar in-born temperaments- the biological component who have experienced significantly different upbringings: family dynamics, economic circumstances, exposure to illness, trauma, stress, and much more, may manifest as adults very distinct personalities and divergent outlooks on life.  By the same token, two individuals with highly contrasting original temperaments may be shaped by their relative experiences and circumstances to develop similar adult character, values, attitudes, and behaviors.  The therapist and clients may examine many different elements and influences on each partner or member and the couple or family while failing to note this most basic foundation of their individual and mutual dynamics.  Temperamental assessment can be used to look at the match between two or more individuals beyond similarity.  As commonly applied to children, temperament avoids value judgment in its descriptions, which can prove provident for the therapist working with an individual's challenges, or the couple or family's conflict.  

"Temperamental dispositions are often described in terms of behavioral style, or the how of behaviors such as their persistence, energy level, as well as valence and intensity of emotional responses (Thomas & Chess, 1977).  Although the what (content) and why (purpose) of behaviors do not fall under the purview of temperament, these aspects of behavior are often linked to temperament, directly or indirectly.  For instance, temperament may be expressed as preferences to seek or avoid certain activities or experiences (what) or as efforts to regulate temperamentally rooted reactivity (why).  All children are born with a set of temperamental attributes, each distributed along the normal continuum.  No single temperamental trait is inherently good or bad but exerts its influence on learning and development in the context of other traits and in response to situations.  The configuration of these attributes, in concert with the child's other characteristics, shapes, the cumulative exchanges between the individual and the environment, thereby influencing developmental outcomes" (Teglasi et al., 2004, page 9).  An individual's temperament can create advantages and challenges to his or her development managing his or her world.  The individual may evoke differential responses from his or her social world: from parents, to siblings, peers, other important authoritative adults, and casual contacts.  This leads to potential predictive relationships between certain temperamental attributes as increasing the risk or vulnerability in challenging situations.  Conversely, certain temperamental traits may offer greater protection and resiliency in the face of adversity.   "Links have been demonstrated between temperament and deficits in social competence" (Teglasi et al., 2004, page 12).  A child's social competence outside of the family and authority figures occurs in relationships with peers.  Eventually for most children, as they mature they engage in romantic relationships with selected peers.  Early social competence predictive of managing challenging dynamics with peers may mirror later competence with intimate adult partners or in parenting demands.

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