7. Antecedents- Distal Elements - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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7. Antecedents- Distal Elements

Therapist Resources > Therapy Books > I Don't You Don't, DepAnxiety-Cple

I Don't… You Don't… It Don't Matter, Depression and Anxiety in Couples and Couple Therapy

Depression and anxiety in individuals often have early childhood historical antecedents that are triggered with current experiences.  The therapist should help the couple identify the historical abuse, trauma, and stress experiences that ignited the first depressions and anxieties in each partner.   An individual is often unaware that his/her current feelings can ignite residual negative feelings from unresolved and/or unprocessed issues from childhood.  The intensity of the current feelings often has to do not just with the current injuries but also from the deep vulnerability still present from childhood injuries.  "Bradbury and Fincham (1988) presented data supporting a contextual model of marriage that distinguishes between proximal elements (such as affect and attributions for relationship events) and distal elements (such as beliefs about relationships in general, personality, and memory) that provide an integrative framework for understanding the role of personality and individual difference variables in close relationships.  The proximal context includes more immediate thoughts and feelings experienced by spouses that are believed to influence processing of events occurring during marital interactions.  Put another way, the proximal elements refer to spouses' subjective, transitory states.  Distal context refers to more stable psychological variables that influence the processing of relationship events that may be directly (e.g., beliefs about relationships) or indirectly (e.g., personality variables) related to relationship functioning.  Bradbury and Fincham argued that although proximal and distal variables create the context for processing relationship behaviors, proximal variables are more transitory and more identifiable to intimate partners than are distal variables.  According to the contextual model, proximal and distal individual difference variables may be associated with marital quality or adjustment in two ways.  First, proximal variables may mediate between distal variables and marital adjustment.  Second, distal and proximal variables may directly and uniquely contribute to marital adjustment, such that a mediating relationship is insufficient to account for relations between distal variables and marital adjustment.  Analyses of the small set of proximal and distal variables included in Bradbury and Fincham's (1988) study indicated that the contextual variables contributed uniquely to the prediction of relationship satisfaction" (Dehle and Weiss, 2002, page 329-30).

Without this understanding the difference and relationship between proximal and distal influences, the individual might unfairly ascribe all of his/her depression, anxiety, and pain to his/her partner's actions.  With insight about unresolved issues that complicate current relationships, antagonistic blaming can be reduced or eliminated if processed successfully in therapy.  The therapist should help the couple identify the proximal triggers (reflecting distal experiences) that ignite the depressions and anxieties in each partner.  If the couple can identify the specific triggers for each partner, then both can work to avoid and to mitigate them.  Normally, these triggers include anything that intensifies the overall stress of the individual or for the couple: financial problems, children, job problems, etc.  In addition, the most stressful triggers tend to be those that have symbolism related to an earlier vulnerability, trauma, stress, or abuse.  Sometimes, partners will ignite perfectly matched (that is, perfectly mismatched) symbolic triggers in each other.

As a little girl, Harper experienced distress when there was a lack of certainty.  The family pattern was to use ambiguity or be evasive about painful information.  This often resulted in a lot of negative experiences in the family.  If Harper's father said he would think about it, it usually meant no.  If her mother said she wasn't sure about a party, presents, etc., it meant Harper would most likely be disappointed because there would be no party.  If no one gave a specific time when Harper asked what time dad was coming home, it meant her father was out drinking.  It also meant no one knew what would happen!  In her current adult life, Harper asks her husband Aiden whether he is going to run an errand after work and about when he would be getting home.  When Aiden answered that he didn't know, Harper would become anxious that something bad would happen.  Symbolically, Aiden's answer was too similar to her experiences in the family.  Aiden insisted he didn't know not because he was being ambiguous or evasive, because he really didn't know!  However, Harper would press him for specifics about what his plans and schedules.  As he tried to explain that he wasn't sure yet because uncertain work demands, it increased her anxiety until she became overtly suspicious and hostile.

Of course, Aiden was upset in return.  But especially, since he couldn't appease Harper.  This was Aiden's trigger because it was too similar to his inability to please his father when he was a child.  His father often demanded that Aiden come up with the "right" answer- an answer that shifted according to his father's moods.  His father would continue to pressure him, and Aiden would feel more and more anxious and inadequate.  His father would often berate and humiliate him for not coming up with the right answer.  Now when Harper pressed him, Aiden felt like that anxious child again.  He became resentful of her.  Aiden didn't recognize that preceding Harper's hostility- the proximal influence or anger was her anxiety about her powerless and vulnerability.  And that preceding the anxiety was her original hurt in childhood- the distal influence.  For Aiden, preceding his resentment or anger at her- his proximal influence pressing him was his anxiety.  And that preceding the anxiety was his original feelings of inadequacy facing his father- in other words, his distal influence.  The therapist can fed back that such historical experiences normally create anxieties that carry forth into adult relationships.  This type of feedback normalizes a couple's processes and reactions.  When this is revealed in therapy, negative symbolisms of "I don't know" and the lack of concreteness for someone like Harper; and of being pressured for someone like Aiden become clear.  The therapist is able to process ambiguity or inadequacy issues often only when they are connected to a basic anxiety from childhood.  Partners other would blame each other for their overly negative reactions.  Therapy can help them first connect and then disconnect from their early childhood experiences.  Partners can be guided to adjust their interactions to be less symbolic and triggering of old anxieties.

3056 Castro Valley Blvd., #82
Castro Valley, CA 94546
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
office: (510) 582-5788
fax: (510) 889-6553
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