* ©2012 by David D. Burns, MD

Do not copy, publish or reproduce without the written permission of Dr. Burns.

When a patient complains of relationship problems—such as a troubled marriage or a conflicted relationship with a family member, colleague, neighbor, or friend—the patient usually depicts himself or herself as the victim and implies that the other person is to blame for the problem. For example, the patient may emphasize the other person’s insensitive or self-centered behavior, and insist that the other person is a jerk who really shouldn’t be that way. Therapists frequently buy into this way of thinking about the conflict. We do this because of our desire to support and help our patients, and also because this is politically correct. And, after all, there is an enormous amount of violence and bad behavior in the world. So when the patient points out all the annoying things the other person said or did, on some level, he or she is right

However, in most cases, you have succumbed to the patient’s hypnotic spell. And once you’ve bought into the idea that the patient really is the innocent victim, the therapy will have little chance of being effective. I’m not aware of any tools powerful enough to help individuals who blame others for their problems.

It is not easy for therapists to escape from this type of trap. In fact, most therapists don’t even realize they’ve fallen into a trap. And it’s somewhat addictive, too. It can feel good to collude with the patient and scapegoat the other person. I see therapists falling into this trap over and over again.

In my psychotherapy eBook[2] (Tools, Not Schools of Therapy) and in my relationship book for the general public (Feeling Good Together), I describe the three basic principles of what I call Cognitive Interpersonal Therapy (CIT). CIT is based on three principles:

1. We forcefully create the relationship problems that we complain about so intensely, but we’re not aware of this, so we feel convinced that we’re innocent victims.
2. We’re not interested in discovering our role in the problem. We want to maintain the façade of innocence so we can continue to do our dirty work in the dark.
3. We have far more power than we think to transform troubled relationships into loving and joyous ones. Furthermore, this can often be done amazingly quickly. However, there will be a price to pay. You’ll have to be willing to pinpoint your own role in the problem and focus all of your efforts on changing yourself, rather than blaming the other person or trying to change him or her. This can be painful, because it requires the death of the ego, or what the Buddhists call “the Great Death.”

I once gave a half-day workshop in Seattle on relationship problems for the general public. It was sponsored by a local hospital as a part of their public outreach program. At the start of the workshop, I asked the participants to think of one person they didn’t like or get along with, and to write down one thing the other person had said to them during an argument or disagreement, and exactly what they said next. I explained that this brief exchange was all we would need to pinpoint the exact cause of the problem and illustrate how to transform hostility and defensiveness into trust and love.

Then I asked if anyone would like to describe the difficult person in his or her life. A woman who was sitting in the first row was waving her hand in the air excitedly, so I called on her first. She said that her name was Martha, and that her husband was the difficult person in her life. She explained that he’d been relentlessly critical of her all day every day for the past 35 years. She said she’d come to the workshop to find out why men were like that.

I explained that scientists don’t yet know why men are the way they are, or why women are they way they are, but if she’d read what she wrote down, perhaps we could get some insight into the cause of her marital problem. What, exactly, had her husband said to her, and what, exactly, did she say next?

She said, “Well, just this morning, he said ‘You never listen!'”

I asked what she said next. What had she written down?

She replied, “Oh, I just said nothing and ignored him!”

The audience erupted in laughter. They could immediately see something pretty obvious that she did not seem to be aware of.

When you use CIT, you examine your own response to the other person instead of blaming him or her, and you ask yourself three questions based on the EAR acronym:

E = Empathy—Did I use good listening skills? Did I find some truth in what the other person said? Did I acknowledge how she or he was thinking and feeling?

A = Assertiveness—Did I share my own feelings openly and directly?

R = Respect—Did I convey warmth and caring to the other person, even in the heat of battle?

Well, it isn’t hard to see that Martha was 0 for 3. First, there was no empathy. She didn’t acknowledge her husband’s feelings or acknowledge any truth in what he’d said. In addition, she didn’t share her own feelings openly and directly—instead she ignored him and froze him out in a passive-aggressive manner. And finally, she clearly didn’t convey any warmth or respect.

This analysis will be threatening to most patients. Martha came to the workshop to find out why her husband was so screwed up. She was blaming him. Suddenly, the finger of blame is pointing at her. This may not be what she had in mind! Because the method is very powerful, it requires lots of trust and warmth, because the patient ends up in a very vulnerable position.

When you use CIT, you also ask the question—what will the impact of my response be on the other person? How will my husband think and feel if I respond this way? What will he conclude? How will he behave?

Once again, the answer is pretty obvious. Martha’s husband will conclude that he was absolutely right—once again, Martha didn’t listen. Since she hasn’t yet gotten it, he’ll have to try again, and again, and again.

So now, Martha knows the answer to her question—why are men like that? Why are they so critical? Sadly, it’s because Martha forces him to be like that. And she’s done that all day, every day, for the past 35 years.

This insight can be extremely painful. I have done this type of analysis myself on many occasions when I was in conflict with a family member, patient, or colleague. And it is always painful for me, too. I HATE having to do this. But it can be very liberating. That’s because of the third principle of CIT—we have far more power than we think to change a troubled relationship. Since we are triggering the problem, we also have the power to change things.

I’ve used this approach with more than 1,000 individuals with troubled relationships, including many mental health professionals who have attended workshop for training and personal growth. In virtually every case, the person who is complaining has failed to empathize, express his or her feelings, or convey respect. So he or she is always 0 for 3 on the EAR analysis. In addition, when you examine the consequences of the patient’s response to the person she or he isn’t getting along with, you discover that the patient is forcing the other person to behave in exactly the way the patient is complaining about.

And we can see that clearly in the example Martha provided. However, this doesn’t mean that Martha’s husband is innocent. If he’d come to the workshop, and Martha had stayed at home, I would have helped him pinpoint his role in the conflict, and he would have made the same painful discovery—that he actually forces Martha not to listen.

I call this the theory of interpersonal relativity. Probably that’s too fancy of a term, but it means that the person who is asking for help will always turn out to be the entire cause the problem.

This approach requires enormous therapist empathy, gentleness and compassion, because the discovery will nearly always be shocking for the patient. Some patients will resist or even decide that they don’t want this type of therapy. But if patients have the strength and good will to endure the discovery that they are triggering the problems they complain about, there will be two huge rewards. First, they will suddenly understand the cause of all of the problems in all of their relationships, because they are almost certainly doing the same thing to other people they don’t get along with. This represents a kind of enlightenment—they discover that they are not, in fact, victims, but are instead creating their own interpersonal reality at every moment of every day. This is a Buddhist principle, but it’s also embedded in practically every religion, including Christianity, the Jewish religion, and many others.

And finally, and perhaps of greatest importance, I can show them how to solve the problem using the Five Secrets of Effective Communication. But that’s a topic for another day.

In a nutshell, most of our patients, and most of us as well, have one or more troubled relationships. Even if patients are seeking treatment for depression, or anxiety, or a habit or addiction, there’s a good chance that at some point in the therapy, they’ll begin to talk about some person who they’re at odds with. They’ll usually try to convince you that the problem is the other person’s fault. If you find yourself agreeing with the patient, ask yourself if you’ve been hypnotized. Once you recognize this, you can break out of the trance and help your patient pinpoint what’s really going on—if she or he is willing. Those of you who want to learn more about the nuts and bolts of doing this may want to read my eBook or Feeling Good Together.

I do not mean to imply that other people are always innocent, and that the patient is the only one who is to blame. In fact, other people often DO act like jerks. We all know that. The patient’s description of how the other person’s annoying behavior is likely to be true. But the patient is nearly always leaving something of vital importance out of the description—and that’s his or her role in the problem.

Thanks for listening! I suspect this blog might stir up a little controversy. Let me know if you have any feedback.

The next blog will cover Error #5, which is by far the greatest therapeutic error of all. So stay tuned!

All the best,

David Burns, MD