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Therapy

Johnny Depp and Amber Heard Needed DBT Couples Therapy

Dialectical Behavior Therapy can save high-conflict relationships.

Key points

  • Conflict arises when intimate partners are highly impulsive, emotionally sensitive, and misinterpret each other’s behaviors.
  • DBT is proven to help severe and complex problems with emotions and relationships.
  • DBT teaches scientifically proven skills for emotion regulation, distress tolerance, and interpersonal effectiveness.
Image by Ryan McGuire from Pixabay
A high-conflict couple.
Source: Image by Ryan McGuire from Pixabay

Many couples and families have persistent conflict when one or more of them struggle with addiction, anger, impulsivity, or emotional dysregulation. These mental health issues are now vividly in the public eye as we watch the civil trial Johnny Depp has brought against his ex-wife, Amber Heard. Depp sued Heard for $50 million saying she defamed him when she claimed she was a victim of domestic abuse.

The courtroom testimony and audio recordings of their conflicts reveal Amber Heard’s deep insecurities and how she retaliated with various forms of aggression. Heard admitted to hitting Depp with her hands, and with pots, pans, and vases, and their couples therapist testified that Heard often initiated their fights. Depp’s team claimed that Heard had a personality disorder. Their trial has been a contentious mess.

Conflict is often the most difficult when borderline personality disorder (BPD) or “complex post-traumatic stress disorder” are in the mix, which often means family members hurt each other often in their childhoods. Depp and Heard had hurtful and chaotic relationships in childhood, and they clearly carried their baggage into their adult relationships. Part of this baggage is usually strong emotional sensitivity and the tendency to negatively misinterpret each other’s behaviors.

I will now describe how to help people trapped in explosive relationships, drawing from my 20 years as a DBT couples and family therapist. Highly reactive couples are quick to argue and blame, and rely on anger to communicate their needs and motivate change. Needing more than run-of-the-mill relationship advice, many fail in typical couples therapy. When destructive emotions are the core problem, no amount of honest conversations or intimacy building activities will be enough. High conflict couples need to get control of their emotions first, to stop making things worse, and only then work on building a better relationship.

Powerful DBT strategies can be used to soften out-of-control emotions that flare up in the relationship. Using mindfulness and distress tolerance techniques helps de-escalate angry situations before they explode into destructive fights. Mindfulness is a way to slow down and observe what’s really going on. My couples repeatedly practice observing and describing external reality, sticking to facts, which also means recognizing when their thoughts are not facts. Thus, mindfulness creates distance from inflammatory thoughts about the partner--such as judgments, negative assumptions, and mind-reading--to reduce their influence on emotions and behaviors.

The GIVE DEAR MAN skill is an effective alternative to judgment and anger to communicate in a clear and collaborative way to give feedback, communicate needs and preferences, and motivate the other to change. Each turn starts by softening up the person to your feedback and requests by first using thorough active listening skills to understand and validate them. “I didn’t like it when you…Help me better understand why you did [not]...?” They find out what was truly in their partner’s mind, rather than relying on their negative assumptions. This is the "check the facts" skill, which requires recognizing “I am having a thought that they…” rather than viewing the thoughts about the other as established facts (mindfulness of thoughts).

When the feedback begins, I encourage my couples to emphasize soft emotions, rather than anger. Soft emotions include feeling disappointed, hurt, sad, lonely, or unloved that are underneath the anger. Many people argue that anger is normal and healthy, crucial for helping us stick up for our rights, values, and boundaries. However, those benefits are overshadowed by the downside of anger blocking communication and collaboration and maintaining resentments. Emphasizing how one feels annoyed and frustrated with their partner can similarly interfere by implying judgment and lack of empathy. The couple is also encouraged to share their longings, fears, and other vulnerabilities. Other strategies help them negotiate and accept differences.

One of the most difficult therapy situations is when one person appears much more dysfunctional than the other, for example, when one partner has BPD, but the other does not. Often, the more reactive spouse has had much more relationship conflict in other relationships, and seems to be responsible for a majority of the conflict in the current relationship--more often overreacting and jumping to conclusions.

It is very easy to take sides, but the therapist must avoid this at all costs! It is very interesting that every social media video I have seen takes Depp’s side, and everybody I know feels the same. I try to maintain balance and compassion while also being real about differences in sensitivity, reactivity, and distortions. The toxic behaviors have been automatic responses to overwhelming emotional suffering, often stemming from childhood trauma and innate emotion sensitivities. Their anger and other emotional behaviors have been automatic responses to feeling invalidated and hurt, when they automatically misinterpret the other’s behaviors. They have been doing the best they can…and now they need to do better.

When there is a severe trauma history, addiction, self-injury, suicide threats, frequent toxic anger, or physical violence, more therapy may be needed. In addition to couples therapy, the BPD person often needs full comprehensive DBT. This full program is often two more weekly DBT sessions for up to 12 months. Standard DBT consists of two separate weekly sessions (one for individual therapy and one for skills training classes) and between-session skills coaching. The DBT individual therapy uses a variety of strategies to reduce reactivity to triggers, and also thorough individualized plans for responding skillfully to the person’s specific triggering events. The skills training groups are highly structured skills lessons, like a class, with weekly skills homework.

Couples therapy is a very difficult process, especially receiving feedback without defensiveness, patiently listening and validating when you feel angry, giving feedback without judgment, being emotionally vulnerable, and giving your partner the benefit of the doubt regarding their good intentions and skills deficits. Even if your relationship has been a wreck, it’s not too late to take charge of healing your relationship. There is effective help waiting.

To find a therapist near you, visit Psychology Today's directory.

References

Alan Fruzzetti (2007). The High-Conflict Couple: A Dialectical Behavior Therapy Guide to Finding Peace, Intimacy, and Validation.

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