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Dr. Michael Evans

On Christmas, open those family relationship puzzles Add to ...

I once saw a comic strip that I often remember during the holidays. It depicted a vast conference hall, balloons floating everywhere, and a loud banner welcoming participants to the "First Annual Conference for Perfectly Harmonious Families."

The hall, of course, was empty, except for three people sitting at a table way at the back.

The holiday season offers a chance to rekindle old friendships, visit with family and generally be thankful for your circumstances and the people in your life. But it can also transform you into a dated and less sophisticated model of yourself. Suddenly you find yourself falling into old patterns of one-upmanship with siblings, and being caught up in relationships that have grown stale and no longer reflect your values.

Your family may have been the one sitting at the back of the conference hall, but on the off-chance that this is not the case, let me introduce you to a newer form of therapy called Interpersonal Psychotherapy or IPT.

Developed in the 1980s by Gerald Klerman and Myrna Weissman, IPT does not focus exclusively on your specific psychopathology but instead focuses on your major relationships: family, work and social. The main idea is that if we can heal our relationships, then we can heal our issues. If you can get to a good place with these social connections, then this is healing.

We can't expect that all your relationships will become perfect (the other person has something to say about that), but IPT can help you put the relationship into perspective. Unlike most forms of psychotherapy, and like cognitive behavioural therapy (CBT), there is quality evidence that IPT works, particularly in depressed patients.

Like many newer forms of therapy, IPT is brief; typically 12 to 16 sessions. IPT does not assume that your problems arise exclusively from interpersonal conflicts, but it does emphasize that your problems play out within an interpersonal context.

So let's conduct some holiday IPT on you and yours. Our first task is to draw up a different kind of "gift list" by jotting down the key relationships in your life.

IPT uses a few general themes to explore relationships. One of the major areas is relationships in which your role has had a significant transition over time. A new job, going away to school, relocation and divorce are all examples of situations that involve relationships with transition. Relationships that are riddled with disputes are another area of focus in IPT.

During the holidays, work-related relationships full of dispute may get better, but if the conflicts are family-based, they are more likely to worsen. IPT aims to help you problem-solve and examine your automatic thoughts (thoughts that are often distorted by your own frame of mind or your typical patterns of behaviour).

The primary focus, though, is on clarification. This may seem simplistic, but, as any lawyer will tell you, trying to clarify the real problem in a dispute can often be very challenging.

One of the reasons the holidays can be so stressful is that it's often a time when we revisit relationships that have experienced significant transitions.

The classic is that of parent-child. If you are the child, the rub is that the parent is still viewing you in a way that doesn't jibe with all the nuances of the current version of you (and, remarkably, this can last into your 70s).

Regardless of whether the transitions went well, or not so well, they put you in a box that doesn't fit any more.

If you are the parent, you are probably trying hard to get it right. You may believe that you know your child in a way nobody else does; sure, the window-dressing changes but your child's character is what it is. You want to steer them on to the right path and hope they may learn from your mistakes.

There may be no right or wrong in the parent-child scenario, so it can be easy to get to an impasse. IPT aims to help you reappraise the old and new roles, to identify sources of difficulty in the new role, and to fashion solutions rather than leave you paralyzed or victimized by it.

You may have too much resentment for a sibling, too much anxiety about your daughter, or be too depressed to see the cup as half full. A good IPT therapist will move you along a path to insight and acceptance, and perhaps even forgiveness.

Ideally this will resolve the dispute, but often the therapy simply allows you to focus on what you can control and builds self-awareness and a path forward.

Interpersonal Psychotherapy and the holidays both have lessons for us about the power of human relationships. I think Bob Hope had it right when he reminded us that "when we recall Christmas past, we usually find that the simplest things - not the great occasions - give off the greatest glow of happiness."

Instead of zeroing in on problems and disputes, perhaps take a simple lesson from IPT and concentrate on the wellness of your important relationships this holiday.

mevans@globeandmail.com

 

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