When someone is dealing with depression, it can have a serious effect on his or her relationships. According to statistics, women experience depression more often than men, and one reason may be that women are more sensitive to social pressures and interpersonal conflicts than men. Interpersonal therapy was designed to help those with depression learn how relationship problems might be contributing to depression. Relationship problems often follow a pattern, and interpersonal therapy seeks to recognize those patterns and help the individual change in favor of healthier relationship behaviors.
Interpersonal therapy can be simply defined as a psychotherapeutic approach that focuses on an individual’s relationships and how those relationships affect the way the individual sees him or herself. Everyone is affected by relationships, and how each person engages in relationships can impact his or her self-esteem, sense of self, and ability to develop loving, supportive relationships in the future. Because depression can have such detrimental effects on an individual’s ability to develop and sustain healthy relationships, interpersonal therapy specifically focuses on working through problem relationships and learning new relationship behaviors.
Michael Yapko, author of Hand Me Down Blues , believes that depression is mainly caused by problems in relationships. He believes that problems with communication skills, conflict resolution, showing affection and making oneself vulnerable in intimate relationships are at the heart of all depression problems. Depressed people are often withdrawn, self-centered, critical, negative, insensitive, and angry, and they often don’t see how these behaviors can interrupt their ability to function in a healthy relationship . Interpersonal therapy seeks to resolve these issues for a depressed individual.
The International Society for Interpersonal Psychotherapy, a group of mental health professionals interested in bringing attention to interpersonal therapy, stresses the singleness of purpose that defines interpersonal therapy. Interpersonal therapy focuses only on relationships. It is a short-term therapeutic approach. Those who practice interpersonal therapy do not believe that depression is caused only by problems in relationships. Instead, it is believed that relationship problems are experienced in tandem with the symptoms and causes of depression.
The Four Areas of Interpersonal Therapy
There are four areas of relationship functioning that interpersonal therapy explores. Interpersonal disputes are situations in which the client undergoing therapy and another person are having a disagreement over expectations. The disagreement has to be severe enough that the individual seeking therapy is experiencing extreme emotional distress that may impair functioning. When someone is depressed, his or her perspective can be skewed. This may cause the depressed individual to blow relationship problems out of proportion or feel unable to discuss disputes in a manner that will lead to resolution. Depression is often accompanied by low self-esteem, and low self-esteem can make it extremely hard for a depressed person to talk about his or her feelings. Low self-esteem can also make a depressed individual defensive and aggressive in relationships. Interpersonal therapy helps guide a depressed individual through communication skills that can lead to more stable relationships. Once adept at communicating with others, the individual will be able to work out interpersonal disputes far more easily.
Therapists can also help a patient with role transitions using the techniques of interpersonal therapy. Depression often involves a shaky sense of identity, and changing prescribed roles in any way can cause emotional distress. When someone goes through a divorce, changes jobs, starts a new relationship or becomes a parent, he or she faces a new facet of his or her identity. If that person has a history of depression or is currently experiencing a depressive episode, the loss of the old identity triggers feelings of grief, and he or she might feel lost or question his or her own sense of self. Interpersonal therapy helps that person get acclimated to his or her new role and let go of the old one.
Interpersonal therapy addresses grief as sadness over the death of a loved one. Grief can be especially difficult for those with depression. A depressed individual may not address his or her feelings toward the loss, and these repressed feelings can cause problems in other life areas. He or she may also feel an outpouring of emotion that is disproportionate to the situation, causing equal dysfunction.
When someone is lacking strong, healthy and supportive relationships, he or she is said to have interpersonal deficits. An interpersonal therapist helps the client recognize relationship patterns that could be threatening the quality of his or her relationships. The therapist often uses his or her relationship with the client as a way of teaching healthier relationship behaviors.
How Does Interpersonal Therapy Work?
In order to help the patient with these four specific relationship issues , an interpersonal therapist will enlist several different techniques. Through questioning and supportive listening, the therapist is able to illicit information from the patient about his or her relationship issues as well as problem behaviors. Because depressed people often experienced what are known as impoverished relationships, simply talking through their problems with a supportive listener can help. “Role playing” is used to help the patient work out conflicts and learn communication, and “communication analysis” helps the client to see where he or she is getting off track in relationships. “Encouragement of affect” gives the client a chance to act out negative emotions such as anger, rage or sadness in a safe and supportive atmosphere.
Michael Herkov, PhD, says that many in the interpersonal therapy community believe that current interpersonal problems are caused by unresolved issues in relationships from the past. By examining these past relationships alongside current relationship issues, an interpersonal therapist can help his or her client realize that strong emotional reactions in current relationships are actually tied to past wounds. Once the client sees his or her past in this light, old issues can be resolved in a healthy manner, freeing the depressed person to experience current relationships in a different way.
Author Michael Yapko gives some simple advice for those facing depression and the effects that depression can have on relationships. He advises that the depressed person seek to establish healthy relationships, learn about and respect appropriate boundaries, learn to control impulses and understand the effect that words and actions have on those around the person experiencing depression. He also advises that the depressed person learn to recognize moods as temporary and not worth causing strife in relationships.
Interpersonal Therapy, Bulimia and the Treatment of Eating Disorders
Interpersonal therapy was originally developed solely for use with depressed people, but recent research has shown its benefits for a range of emotional disorders. A study performed at the Oxford University Department of Psychiatry showed that interpersonal therapy is as effective for the treatment of bulimia as cognitive behavioral therapy. The publishers of the study are quick to point out that interpersonal therapy and cognitive behavioral therapy are very different from one another, but finding a way to use both together might make for the most powerful bulimia treatment possible. Because eating disorders such as bulimia are often very closely tied to a breakdown in identity formation and interpersonal deficits, interpersonal therapy may be able to help those suffering with bulimia work through role transitions and interpersonal disputes that may be fueling the disorder.
Other Disorders for Which Interpersonal Therapy is Beneficial
Interpersonal therapy can also help anyone experiencing a family or marriage dispute. An interpersonal therapist may be able to help couples and families discover the relationship patterns that are causing conflict and help them reach a resolution that supports all parties. Learning to set boundaries, communicate openly and honestly in relationships and maintain one’s sense of self in the context of a relationship are some skills taught in interpersonal therapy that anyone could find useful. Interpersonal therapy is a therapeutic approach that doesn’t just lead an individual away from depression but supports him or her in making life all it can possibly be.