The Feeling Good Therapist - Interpersonal Downward Arrow Technique

Interpersonal Downward Arrow Technique with host, Richard Lam, LMFT, featuring Kevin Cornelius, M.A., LMFT

*This Technique was developed by Dr. David Burns, American Psychiatrist and Adjunct Clinical Professor Emeritus of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine.

In this episode of the Feeling Good Therapist, Richard Lam introduces Kevin Cornelius, who demonstrates the Interpersonal Downward Arrow Technique CBT, developed by Dr. David Burns. This method helps clients understand their roles and rules within problematic relationships by making unconscious patterns conscious, allowing them to make informed changes.

In the role-play scenario, Richard assumes the identity of "Javier," a man struggling with his wife’s frequent complaints and their resulting conflicts. Kevin guides Javier through identifying descriptive adjectives for his wife (e.g., complainer, troublemaker) and himself (e.g., problem solver, compliant). They explore the emotions these roles elicit, such as frustration, annoyance, and confusion, and uncover the underlying rules, such as feeling compelled to solve his wife's complaints and not expressing his own emotions.

This session provides a clear downward arrow technique example, highlighting the benefits of bringing these dynamics to light, offering a pathway for personal growth and improved relationships.

IN THIS VIDEO: 

Richard: Welcome everyone to the Feeling Good Therapist, where we learn skills and tools to help you in your own practice or in your own personal lives. My name is Richard Lam. Today, we have Kevin Cornelius, who will be helping us learn a really awesome technique called the interpersonal downward arrow, a technique created by Dr. David Burns. Welcome, Kevin.

Kevin: Well, thank you, Richard. It's great to be here. Yeah, I'm really excited to demonstrate this method. Really great when we're using the interpersonal model. It's a good tool for helping patients understand their role in the problems they're coming to therapy for. So I'm excited to do this with you.

Richard: Wonderful. Same here. Tell me a little more about the potential patient I'd be playing today.

Kevin: Yeah, I think we're going to be working. You'll play the role of a man who's married to a woman. His wife has been – he's unhappy because she complains a lot to him, and then he jumps in and tries to help her with her complaints, and then she gets upset with him because he doesn't listen to her well. So he feels like I can't do anything right. Is it okay for you to play that role today?

Richard: That's a really great example. Let's do it. Okay, good.

Kevin: Should we make up a different name for you when you're playing a role so it's – clear that you're not Richard?

Richard: Yeah. Let's do Javier.

Kevin: Great. Okay, Javier. So Javier, first of all, I'm really happy to be working with you today. And I'm really impressed by the way that you've been willing to take full responsibility for making all the changes in this relationship. And, of course, we've talked a lot about what this has been like for you. And I'm happy to hear that I'm understanding you well and that this would be a good time for us to use a method to help you make changes. Am I getting all that right?

Richard: Yeah, I'm just ready to really improve this relationship already.

Kevin: Okay, great. Well, a logical next step for us would be to use a wonderful method called the Interpersonal Downward Arrow. And this is an uncovering technique. And what we're going to be uncovering is the roles and the rules that you've been playing and following probably unconsciously in your marriage.

We're going to bring them to conscious awareness, and then you're going to have some choices about whether you'd like to continue playing those roles and following those rules or if there are some changes you would like to make. Is it okay if we give it a try?

Richard: Yeah, sounds interesting.

Kevin: Okay. Well, I'm going to share my screen with you, Javier and we will look at a special form we use to do this. I sent you a copy of this so you can use it on your computer and fill it out, too.

You'll see that there are four quadrants here on this page. And we're going to start up here in this upper right-hand quadrant. And we're going to take a look at the role that your wife plays in the problem that you were describing to me in your relationship. And I'm going to ask you to list some adjectives that describe her role. Like, what kind of person is she?

So you were saying that she does a lot of complaining. And then, when you try to help her with her complaints, she gets upset and angry because you're not listening to her. So, what's a word that would describe her in this situation?

Richard: I'm not sure if this is considered an adjective, but maybe like a complainer?

Kevin: Sure. Let's put that down. Complainer. Anything else that jumps to mind?

Richard: Well, she's always complaining. That means she's always running into problems. So maybe like a troublemaker?

Kevin: Okay. Troublemaker. Yeah. Very good. What else comes to mind?

Richard: I don't know. Do you have any thoughts on that?

Kevin: Yeah, well, one thing that stood out to me is that it really bothered you that she comes to you with a problem, and then all you're doing is just trying to help her, and then she gets mad at you. That sounds kind of unreasonable or unfair. Would one of those words be a way to describe her?

Richard: Sure. Unreasonable.

Kevin: Okay. Or maybe even another word that jumped into my mind is maybe a little demanding.

Richard: Oh, yeah, for sure.

Kevin: I've got a couple of other ideas, but I'm wondering if any others are jumping into your mind because what you think about this is important.

Richard: I think she's unempathetic because I'm trying to put effort into it, and she doesn't understand all the hard work I'm putting in.

Kevin: I think that's true. Let's put that unempathetic. So she doesn't really notice what this has been like for you and the work that you've been putting in. Is that right?

Richard: Absolutely. Yeah. I'm also unappreciative.

Kevin: Sure. Let's put that down too. Make sure you're writing these down on yours also because you're going to want to hold on to this form when we're done with this. And, you know, one thing that jumped into my mind that I checked with you on is, do you think that maybe her role is to be critical?

Richard: Yeah, she's definitely the critical one.

Kevin: Okay. So let's put that in there too. Okay. We have a pretty good list going here, but it seems like something we could probably work with.

Do you think we've captured things well, or should we put down another couple of adjectives?

Richard: No, that sounds perfect. This looks like exactly her role.

Kevin: Okay, so far, we're saying her role. And let's think if her role is to complain, be a troublemaker, unreasonable, demanding, unempathetic, unappreciative, and critical, what describes your role?

Richard: More of the problem solver. And maybe the more level-headed one. If she's unreasonable, I guess that makes me reasonable. And what's the opposite of demanding here? Because I'm definitely one that complies with her demands. Yeah, compliant.

I think I'm very empathetic since I'm always trying to help her. Maybe the helper would describe her role, too.

Kevin: Yeah, something that jumped to my mind when I'm looking at demanding; it kind of sounds like you're sometimes pretty acquiescent, right? Like you give in to the demands and try to help.

Richard: Yeah, absolutely. That fits that perfectly.

Kevin: Hopefully, I'm spelling it right. That's a $5 word there, but okay.

Well, that's a pretty good list too. Do you think we're capturing your role well here?

Richard: Yeah, absolutely.

Kevin: Okay. So now what we want to look at is what this feels like, right? What kind of feelings come up for you, like when you're being a problem solver, level-headed, reasonable, compliant, empathetic, a helper who's acquiescent, interacting with your wife who's a complainer troublemaker, etc? What are the kinds of emotions that you feel?

Richard: Oh gosh, I feel very frustrated and annoyed. And at the same time, I feel a little bit self-conscious because I'm not sure what I'm supposed to do. She's always telling me I'm not doing the right things and really get angry, actually. Afterwards, I don't understand trying to help her, and she's telling me that I'm not helping. So really. Yeah.

Kevin: Do you feel at all defensive when you're being criticized?

Richard: Oh, yeah, for sure. Yeah. I'm always telling her I'm trying to help. I don't understand.

Kevin: Yeah. Maybe confused.

Richard: Yeah. Very confused. I don't really get it.

Kevin: Okay. Yeah. I also wonder if you feel hurt. When you're stepping in and trying to help, when you're hearing complaints, you get an angry response.

Richard: I do feel hurt. Okay. At the same time, I also feel a little anxious. Like, I had to walk on eggshells. I don't know, like, if I'm going to upset her even more. So I don't really know what to say.

Kevin: Yeah. Okay. Yeah. And I guess the last question I have is, does this feel lonely?

Richard: Oh, gosh. Yeah, it does feel really lonely. I feel a little bit disconnected if I were on my own. We're supposed to be a team here, but we keep running.

Kevin: Okay. Yeah, so I jotted down the feelings as you listed them here. So when you're in these roles, you know, with your... With your wife, you're feeling frustrated, annoyed, self-conscious, angry, defensive, confused, hurt, anxious, lonely, and disconnected. And there's a final piece here that we'd like to take a look at. What do you think are the rules? And I would describe these as unconscious rules. It's not like you're sitting down and choosing to follow particular rules, but to maintain these roles and how it feels, what are the rules you're following, do you think?

Richard: Well, I think one rule is when she complains, I have to come up with a solution.

Kevin: Sure. Yeah. When she complains, I have to come up with a resolution. Sure, um, anything anything else?

Richard: Yeah, I think another one is when I come up with a solution, she gets upset with me, and her role is to, I guess, tell me that it's a bad solution.

Kevin: Yeah, what's the rule being followed there, and when does that happen?

Richard: She has to disapprove of any solutions I come up with.

Kevin: She has to disapprove of any solutions. Yeah. And when she disapproves of these solutions, what's the rule that you then must follow to maintain this status quo right now?

Richard: I guess I defend myself. And explain myself, defend and explain myself.

Kevin: Okay. And, you know, there's something that just jumped into my mind as I was considering these roles and the feelings that come up for you.

It looks like there's not really a chance for you to talk about what this feels like for you. Is that right? Like maybe a rule that's being followed is, you know, I must not talk about my feelings because it's sort of the way that maintains these roles is that she can express her, you know, hurt and anger and frustration towards you, but that you don't have permission to do that or something. Am I reading too much into it?

Richard: That sounds very true. Yeah, I don't really express my emotions. I'm just supposed to listen to her.

Kevin: Yeah, so I must not express my emotions, but I must listen to hers. Is that right?

Richard: That's right.

Kevin: Okay. Now, there's a lot that we're uncovering here right now, Javier, right?

Like we've made, you've really jumped in and looked at these roles, rules, and feelings, and I'm just wondering what's this like for you right now, like what do you notice about yourself as you're considering all this.

Richard: Well, I know I don't like it.

I mean, look at this. It's like this pattern that doesn't really work out so well. And we always argue, and no one's happy at the end of the day. And as you can see, I have a lot of emotions.

Kevin: I want to say that I really like that you're willing to look at it in this way because it's hard, right? And, you know, of course, there's lots of positive things that are true about your marriage too.

And we're just looking at the negative things, right? That maintains the problems here. And I think it's helpful that you're willing to look at it this way and the way that this feels. And there's a logical next step here. that I'd like to explore with you.

Richard: Thank you, everyone, for watching part one of this video of Kevin Cornelius of the Interpersonal Downward Arrow. Part two will be linked below once it's released. Please check out that video. If you want to learn more about Kevin, also please look below. Lastly, please also consider subscribing to learn more about Therapy Tools content.