4. Indicators Communication Therapy - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Mirror Mirror… Reflections of Self-Esteem in Relationships and Therapy
Chapter 4: INDICATORS FOR COMMUNICATION THERAPY
by Ronald Mah





Communications oriented family or relationship therapy holds that poor communication caused or will cause the loss of self-esteem.  Low self-esteem is thus seen as the basis of dysfunctional relationships.  As such when the therapist observes low self-esteem in an individual, either partner, or one or more family members, it is indicative that enhanced communication would become an important thrust of therapy.  Underlying Terry and Bert's hostility and defensiveness with each other may be from each individual's insecurity about being inadequate as parents, unable to stay together, and worse yet, having shame from being as bad as their parents.  Better and improved skills in giving and receiving communication become key to giving and gaining self-esteem, and thus improving relationships, if all levels impacting functioning are incorporated.  A member or members and the entire system must learn for example, how to identify the implicit aspects of communication (covert communication) that are sensed, assessed, and responded to subconsciously in addition to the overt communication (the words spoken).  Poor communication, frustrated interactions, and dysfunctional relationships create identifiable characteristics.  Whether these negative characteristics or dynamics create problematic communication and relationships or problematic communication and relationships cause the characteristics, they remain important for the therapist to recognize.  They can indicate the use communications oriented therapy or interventions.

BLOCKED OR INAPPROPRIATE EXPRESSION OF FEELINGS
An individual with low self-esteem often is insecure interacting with others, perhaps especially with an intimate partner with whom he or she is highly invested in.  An anxious individual may have difficulty in expressing him or herself in high stress situations.  For example, as the person becomes more anxious speech disturbances may increase.  "Both Mahl and Osgood (Bradac et al., 1976) found support for the hypothesis that anxiety is cognitively disruptive and that such cognitive disruption results in a high nonfluency rate" (Paul et al., 1986, page 177).  "Decreasing question specificity, an arousing topic, and high-status interviews" was related to greater disfluency, which indicates anxiety.  This can be highly descriptive of the intensity of couple's arguing.  Thoughts and feelings become jumbled within one or both partners, which preclude either being ability to communicate them accurately to the other.  If one partner has difficulty translating his or her internal process, it almost inevitably confuses the other partner's process at the same time.  The therapist may recognize this in the person in individual therapy describing his or her communications with another, especially when having difficulty articulating his or her and/or the other's internal emotional process.  "…mutual recognition or a mentalized understanding must precede any sort of agreement (or agreement to differ)" (Pizer and Pizer, 2006, page 80).  Being out of sync intrapsychically emotionally and cognitively, makes being in tune with the partner difficult if not impossible.  When one person makes an accusation, the accused person may immediately become defensive.  This was characteristic of Bert in reaction to Terry's complaints.  The vulnerable versus a more secure part of the accused takes control.  Rather than expressing the core vulnerability that has been activated, anger or aggression is expressed.  In a defensive-offensive act of reversible complementarity, the accused names the accuser as the transgressing person.  The original accuser does not examine what the accused person means by that, but reacts by being condescendingly dismissive.  "Understanding or recognition between opposing parties is a prerequisite to negotiation, and understanding is not synonymous with agreement" (page 80).  Thoughts and feelings are blocked by the reactive attack and defend cycles of the conflictual individuals.  They are not clearly expressed.  Even if expressed or implied, thoughts and feelings are swept aside amidst the verbal daggers and emotional parrying.  The therapist works to bring underlying thoughts and feelings to the forefront of the relationship conversation.

COVERT COMMUNICATION
Communication can be direct and overt.  Specific meaning and intent are expressed clearly so that the recipient is clear about feelings, logic, motivations, and desired response or reaction.  Speaker-sender intent and listener-recipient understanding tend to be more in sync as direct and overt communication does not require much if any interpretation.  Direct communication does not depend heavily on mutual understanding of implicit messages.  A person who is powerful and secure is most likely to use direct communication.  Direct communication however has potential complications.  It exposes vulnerability in the speaker, and can create obligation in the recipient.  Both can be dangerous.  Presenting what one wants directly gives others knowledge of ones needs.  That can be exploitable.  It also gives the other person the opportunity to invalidate the speaker's desires.  That can become a basic existential denial of his or her right to feel or to be: "How could you ask for that?  Who do you think you are?"  When a person is asked for something, it can create danger in two ways.  First, it may overtly acknowledge the power inequity of the asker to the more powerful asked.  In societies where being acknowledged as having more power, status, or resources labels one an object of envy, this distinction may be accompanied by a greater danger of being targeted by the less powerful.  Secondly, when one is designated as the more powerful, as the person in control, it can create the obligation to serve the supplicant despite possibly not wishing to.  Using cultural values of obligation to manipulate more powerful individuals can be dangerous to the manipulator.  

Covert or indirect communication may be culturally promoted.  If a person has low status and lacks protection from abuse, indirect communication becomes the obligatory and safest way to express needs.  Modern American society in comparison to many societies, especially older totalitarian societies has a lot of legal protections for confronting inequities.  However, experiences both from outside American society and within American society greatly qualify the security of individuals to express openly disagreement or opposition.  In America, authority figures can be criticized without the degree of fear of retribution as compared to less democratic societies.  Societies (such as traditional Asia) or historically marginalized or oppressed segments of society (such as African-American or Native American communities) or couples or families (such as in a patriarchal totalitarian and abusive home) lack a tradition or experience of individual democratic rights.  Where life, property, freedom, and security can be snatched away by powerful individuals or forces (including the government, or a parent or partner), a practice or culture of avoiding confrontation develops.  Note the following stereotypical wife/husband communication between Ethan and Isabella.  

When they were married, when walking at the mall store, Terry spotted something and says, "That's a nice dress.  I have shoes and a belt that match that dress.  I haven't gotten a new dress in a long time.  Is there going to be an office party this year at your work?"  Why in this communication is there not a direct request or statement, "Can we buy that dress?" or "I want to buy that dress."  By asking indirectly, Terry had avoided humiliating herself by acknowledging that she did not have the power or authority by herself to make the decision.  This would acknowledge her inferior power relative to Bert.  By asking indirectly, she avoided putting Bert on the spot to please or disappoint his mate.  Since much of Bert's self-identification as a good husband was culturally defined according to his ability to provide for his wife, indirect communication allows him to deny the request without verbalizing.  Unfortunately for them both, they played out versions of this communication with growing resentment in Terry for not having power and being turned down.  Bert became more resentful as well sensing her increasing hostility for no apparent reason.  On the other hand, if flush with money Bert could have replied, "Uh huh.  Let's go look at the stereos."  This response or non-response avoided being humiliated by admitting his impotency (financially) in pleasing his mate, Terry.  Or, Bert could have magnanimously and safely express "love" by saying, "Why don't you try it on?  If it fits, let's get it!"  This dynamic exists less often when there is equity of power and control between partners.  If Terry and Bert had equal power and control, Terry would not have had to ask to buy the dress.  She could have decided to get it on her own.  And, Bert would be fine with it if doing so was in sync with their agreed budget.  On the other hand, there may be functional equity in the decision making process, but partners may carry forth the cultural traditions from previous experiences or the family-of-origin.  The therapist should look for mismatched indirect communication or negative intent using indirect communication between partners.  "…martially distressed subjects were more negative on… intent, perceived intent, and predicted impact… This pattern supports the general hypothesis that the valence of communicative intentions and related constructs have relevance in marital communication and marital satisfaction… distressed wives made significantly more negative message ratings… In particular, martially distressed wives' ratings of message intent and their prediction of message impact were significantly more negative than same ratings made by martially distressed husbands and by both nondistressed husbands and wives... wives might provide… confirmation of the suggestion that wives might provide a more sensitive indicator of marital distress than do husbands (Floyd & Markman, 1983)" (Denton et al., 1994, page 23).

Since women have traditionally been less powerful and more vulnerable in heterosexual couples, they have a greater investment in being in aware of the quality of the relationship, as did Terry.  Men who traditionally dominated in patriarchal cultures would thus hold greater power and control in the couple.  They would experience less inequity or would benefit from inequity and therefore, be less likely to hold grievances.  And if they experienced grievances, as the more secure and powerful partners would feel more freedom to openly communicate their complaints to female partners.  They can more easily act on their motivation to seek redress.  "…motivation plays a role in marital communication and… motivation may interact with gender.  A potential clinical implication would be that therapists need to consider and address the fears and hurts that might motivating their clients' objectives in marital communication… It is likely that pure skill-teaching approaches to therapy indirectly address the matter of motivations since one subject couples are usually asked to discuss during the skill-building exercises are their feelings about each other's behavior" (Denton et al., 1994, page 25).  The more secure and powerful individual would not be motivated to use indirect or covert communication.  This might have been true for Bert as a male, but other insecurities from family-of-origin and other life experiences had difficulty finding his voice with Terry.  The less secure or disempowered individual (that Terry felt he was periodically) would feel compelled to avoid direct communication, since it could be perceived as confrontational.  That would be a confrontation that such a person would not feel safe to engage in.  The therapist often has to work through covert or indirect communication to ascertain the true meaning of messages.  Teaching direct communication may be a simple cross-cultural activity, but may also involve examining personal and historical experiences of disempowerment.  One or both individuals, such as Terry and Bert may need to be empowered to speak directly.  A significant indirect communication that may occur in couple therapy may be the enthusiasm of one partner to "work on better communication."  "Better communication" may well be the partner's indirect communication of his or her major disappointment in the relationship, anger and pain at being dominated and/or ignored, being ready to divorce, a sense of betrayal, abandonment, or rejection, and similar grievances.  The therapist should be alert to possible other communication that convey covert messages to him or her about the expectations for therapy or the condition of the relationship.  Failure to note and address such messages may duplicate the failure of communication already endemic in the relationship- for example, the first failed relationship of marriage, and the second failing relationship of co-parenting for Terry and Bert.  Bringing them to the attention of the individual, couple, or family for overt examination can be extremely productive for building trust and rapport between the individual, partners, the couple, family members, or the family and the therapist and for the relationship.

OPEN VS. CLOSED COMMUNICATION
Certain communication styles close off communication, while others keep communication open between and among members of the system.  Identification of communication styles leads to teaching open styles and to reducing closed styles.  A closed style can cause individuals to get stuck rehashing the same arguments repeatedly.  Rigid concrete thinking and set assumptions about each other and the relationship do not allow for growth or change.  The therapist should try to break this pattern and teach more open communication styles.  For example, Pizer and Pizer (2006) suggest an activity called the "Cherished Object Exercise" to try to break perpetually closed communication.  "In this exercise, the work begins at home and then continues in the consulting room.  We ask each partner to bring to a session a cherished or particularly meaningful object, placed in a bag or otherwise concealed from view.  During the session, we ask each person to bring the object into view by placing it on the low table that we have set in front of the couple.  Each person, supplied with paper and pen, is then asked to write down a description of the object in two ways: first, a paragraph on what the object looks like and feels like, as if to help a radio listener picture the object in its form, material, function, and so on; second, we ask each partner to describe how this particular object has acquired an important personal meaning.  Once the writing is completed, each partner reads what he or she has written" (page 87-88)

The intention is that the exercise may provoke small steps from rigid deterministic thinking to looking at the meanings of things and interactions.  As the individuals talk about the object, the therapist can evoke contemplation the deeper symbolic importance of not just the object but also of other things and experiences between the two people.  Many people express the conclusion of a series of feelings and interpretations without revealing or even being aware of them.  While cherishing an object, an individual may not be able identify and articulate how it got its value.  For example, it may be difficult to get Terry to say, "I spent a lot of time with my grandma, because my mom had to work so much.  Dad was pretty much gone.  This little oilcan was for my grandma's sewing machine.  Nana always made me feel special with the pretty dresses she made for me.  She said she loved making clothes for her 'little doll Ter-beary.'  The little oilcan reminds me of Nana's attention and how I was her 'little Ter-beary' when I wasn't feeling very special to anyone else.  I can smell the oil a little bit still.  It makes me feel warm all over."  Terry's cherished object is another piece of junk without the story and meaning behind it.  When Bert had let the kids play with it and they could not find it right away, she got really upset.  Bert thought Terry was crazy- totally and unnecessarily dramatic.  Bert did not have any idea of how special it was to her until she told her story.  

Bert took out his wallet to share as his cherished object.  "This was my big brother Mychael's wallet.  It's kinda of beat up.  He gave it to me when I was eleven years old.  I really looked up to him. He was a Marine and he was shipping out.  I can remember that day like it was yesterday… July 14, 1990.  Mom was crying.  Mychael was going to Iraq… Desert Storm.  He never made it back.  It's all I have of his… of him."  Bert had never told Terry the story behind his beat up raggedy wallet.  She had teased him about it and had bought him a nice leather wallet for his birthday once.  He had never used it.  Terry had been miffed that he did not seem to appreciate the gift.  Only with this exercise, did she realize why he was so attached to the old wallet.  Terry could not throw away his connection to his adored long lost brother Mychael.  When each person shares about his or her special thing or experience, they find that they both have meanings previously unexpressed.   This facilitates a sense of connection.  "You too?  We share similar experiences.  I didn't know."  When they realize they share some vulnerability, two people may be able to open themselves to greater reflection about selves and the other.  They may be able to listen beyond and beneath the overt message that may be sensationally triggering.  Instead of shutting down or sticking with negative interpretations, reflective listening may allow individuals to explore alternative less antagonistic motivations and the other's underlying vulnerabilities.  The therapist should stay vigilant for closed communication in the relationship.  He or she continually works with individuals to practice more open communication styles.  A sense of loss, a hurt, a time of loneliness, the experience of rejection or of being misunderstood… any of these experiences or feelings can open communication as well as an object with meaning.  If the therapist can get the individual to realize, "I felt what you felt once too," shared vulnerability slightly cracks open the closed communication door.

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