Blame, Denial and Power: The Holy Trinity of Relationship Problems in CBT

TEAM Therapy’s concept of the core problem in the treatment of relationships may sound simple: As long as our client continues to blame the other person for the problems in their relationship and denying their own role in creating or maintaining the problem, they will remain powerless at creating a positive change in their relationship. This concept is enormously helpful, but it’s not easy to get this point across without losing therapeutic alliance. Let’s say we are working with Didi, a pleasant professional woman in her thirties. She comes to therapy individually because she feels unhappy in her marriage and her husband “doesn’t believe in shrinks.” When she is asked to describe the problem she’s looking for help with, she says: “I sometimes think my husband is on the autistic spectrum. He doesn’t listen to me. I have to ask and ask and beg and repeat myself again and again before he’ll consider any of my opinions or desires, or even grant me with an answer.” What do we do next? How can we help Didi change around her relationship, especially without even having her husband in the room?

According to TEAM Therapy, there is A LOT we can do! But not before Didi understands the concept of blame, denial and power. There are many powerful tools we can use and teach her to help her relationship once she is ready to examine her own role, and learn new interpersonal methods and techniques. However, to help Didi, at first, our role is to disarm, stroke, and show we understand. We need to present these empathy methods with warmth and caring, otherwise we’ll miss what may be a great opportunity. After we listen and empathize for a while, we can use our paradoxical agenda setting techniques while introducing the concepts of blame, denial and power. We may be able to find a way to let Didi know that she is indeed powerless about changing the relationship in the way things are going, but that there are ways of gaining back that power. Perhaps after a while longer, and after we are convinced that Didi is interested in achieving more closeness and intimacy with her husband, we can assess her readiness to do the work involved by saying something like: “You’ve shared how difficult it’s been for you to deal with your husband and even though you feel so much pain about it, you also shared your desire to achieve greater closeness with him. Right now it seems like you have very little power to do so. I have many powerful tools I could teach you that could help you change your relationship around, however I’m concerned that asking that of you would be extremely unfair, because in order to do so, you are the one who is going to have to do all of the changing, even though it’s him who is mistreating you. I feel hesitant to even bring this option up because it seems so unfair. The only way of gaining back the power of change in your relationship is if we take a radically unfair look at your relationship dynamics and hold you 100% accountable for the relationship. I can see so many reasons why you wouldn’t want to do that. What are some of your thoughts and feelings hearing this?”

Although it may not be evident at first glance, this is a very hopeful message to our clients, who often come to us feeling hopelessly stuck in painful patterns in their relationships. This simple concept of blame (of the other) and denial (of their own role) is unpleasant and can be embarrassing to think about, yet it holds a great promise of getting our client back in the driver’s seat of their relationship’s fate, and clearing a way towards positive change. Once we set the goal with the client, and we both understand what it takes to get there, we can pull out our bag of interpersonal methods and work effectively together.

If you are interested in learning more about this approach, check out Dr. Burns’ book “Feeling Good Together”. Therapists may also join our upcoming TEAM-CBT workshops.