CBT for Relationships

How Can CBT help with Relationships and Communication?

Romantic Partners. Co-workers. Children. In-laws. Friends. No matter what type of life you live, you are probably surrounded by relationships — relationships that can contribute to a great deal of fulfillment, or a great deal of conflict.

In relationship-oriented cognitive therapy, we focus a great deal on improving the quality of the relationships in your life. Harmonious relationships can strongly support a sense of inner peace; conflict-filled relationships can interfere with it. Along with the "inner" shifts in therapy, it's also important to work on interpersonal dynamics.

Communication Skills

One of the greatest sources of conflict in relationships is the use of ineffective communication skills. Most people engage in a great deal of blaming, controlling, criticizing, and avoidance in their relationships — communication approaches that virtually guarantee relationship conflicts.

Therapists draw on a wide variety of proven communication approaches in order to improve relationships. In my work, I sometimes use what I call the ECHO approach (inspired by Dr. David Burns' EAR approach) to summarize four effective communication skills. These include the use of Empathy, Courtesy, Honesty, and Ownership. Let me briefly explain each of these elements:

Empathy: In the world of psychology, "empathy" refers to the ability to see the world through someone else's eyes. As a communication skill, the use of empathy can be extremely disarming and conflict-reducing. Those who use empathy effectively help their partners to feel understood and heard. Beginning a discussion with an empathetic statement helps to de-escalate conflicts.

Courtesy: The ability to maintain a sense of courtesy and respect for your partner even when you are upset is an extremely important skill. Many people display only a moderate amount of courtesy and respect even under normal conditions. When conversations become heated, courtesy can vanish completely. Learning to face conflicts in a spirit of respect is an essential communication skill.

Honesty: Emotional honesty involves not just verbal expression, but also a willingness to become more self-aware. Learning to look below your immediate thoughts and feelings to deeper ones that might reside below is an important skill. These deeper thoughts and feelings are often more vulnerable, less blame-oriented, and ultimately more honest. Communicating from this deeper place leads to far less interpersonal conflict.

Ownership: Perhaps the most difficult of these communication skills involves learning to take responsibility — or ownership — for our thoughts and feelings. In the midst of interpersonal conflict, the human mind has a tendency to blame other people for its thoughts and feelings. Reversing this tendency usually requires practice. And yet, the skill of ownership is a powerful one.  Assuring your partner that you are taking responsibility for your thoughts and feelings can change the entire tenor of a conversation.

Combining each element of this ECHO approach in a natural way can reduce conflicts and miscommunication, and lead to a more harmonious way of relating. And of course, there are many other skills that can be woven into this system. In cognitive therapy, we practice using and refining these types of approaches until they become second-nature.

Altering Patterns

In addition to developing more effective communication approaches, it can also be helpful to identify repetitive patterns that lead to conflict. Once unhelpful patterns are acknowledged, they can be changed.

One approach that we use in cognitive therapy involves a "stimulus-response" model. The idea is that a stimulus (for example, seeing your partner's socks lying around the house) sparks a response (irritation and arguments). The more that the old response is used, the more "automatic" and ingrained it becomes.

In cognitive therapy, we focus on the idea that you are always free to develop new responses to stimuli — responses that are self-supportive and contribute to relationship harmony. The more you use the new responses, the stronger and more automatic they become. The old, conflict-producing patterns begin to fade away through disuse.

Here is a simple example:

In this case, the person replaced the old response with a new one that involved consciously choosing self-acceptance and self-care, choosing to have compassion for the criticizer, and choosing to seek a win-win solution to the issue at hand.

At first, this new response might feel unnatural. It might require effort and conscious practice. But over time, the new response can become a healthy habit. Eventually it will simply "kick in" on its own.

In cognitive therapy, we work to identify old patterns, choose new alternatives, and begin to practice them through discussions and role-playing. We then refine or modify the new approaches depending on how they work in the "real world." The goal is to replace stress-producing relationship patterns with self-supportive, peace-producing new ones.

Anger Management

At times, relationships can be a source of intense emotional strain. For some people, the stresses of a relationship spark extremely strong feelings. When these feelings take the form of angry outbursts or violent behavior, relationship conflicts can spiral into dangerous situations.

Cognitive therapy can help to identify "triggers" for anger-based responses, and modify the internal perspective that leads to the anger. Interestingly, a great deal of anger is influenced by "self-talk" statements that might be difficult to notice. In therapy, we shine a spotlight on this inner self-talk and modify it in a healthy manner.

In addition, we work to build a new base of responses, so that when you find yourself in challenging situations, you will have new response options to draw upon. As we practice using these, they become more accessible.

Needless to say, it is far better to seek help with anger management issues at the first sign of trouble, rather than waiting for situations to escalate into violent conflicts.

For additional information on relationship and communication skills development, you can review the following Q&A's: