Dr. Mark Goulston is a former UCLA professor who helps high performing leaders, senior management and sales people reach their full potential using skills he learned training FBI and police hostage negotiators. He is a member of the National Association of Corporate Directors and the Worldwide Association of Business Coaches and writes the weekly Tribune syndicated career advice column, "Solve Anything with Dr. Mark" and columns on leadership for FAST COMPANY and Directors Monthly . He is frequently called upon to share his expertise with regard to contemporary business, national and world news by television, radio and print media including: Wall Street Journal, Harvard Business Review, Fortune, Newsweek, Time, Los Angeles Times, ABC/NBC/CBS/Fox/CNN/BBC News, Oprah, and Today. Mark Goulston is the author of The 6 Secrets of a Lasting Relationship, Get Out of Your Own Way: Overcoming Self-Defeating Behavior,  Get Out of Your Own Way at Work and PTSD for Dummies. For more information visit: www.markgoulston.com.

Guest Blogger Mark Goulston--

Here we were again. Back at Defcon 1 with the husband and wife I had been seeing in marital therapy every other week for three months. 

            Neither was listening, each was taking everything the other person said personally, and both were on the defensive engaged in full frontal counter attacks.   I thought to myself, "This is going to be a long 90 minutes," and questioned whether I could get them back to Defcon 5, where they could leave my office and at least go back to sleeping in the same bedroom after another week of sleeping apart.

            Two weeks earlier they had been in to discuss his being emotionally distant and her being emotionally over the top in their communication.  It had taken most of that session for them to see that engaging in a "chicken in the egg" blaming contest was getting them nowhere.  The breakthrough had come at 60 minutes into that 90 minute meeting when she finally understood that he emotionally shut down not to reject, punish her or as she accused him of "always getting angry and then always running away." Rather, it was to protect her from -- as he put it with a "don't push me" glare in his eyes – getting angrier.  It was at that moment of authenticity, that she felt he was emotionally present in the room as opposed to being emotionally shut down.

            I asked her if he in fact "always" got angry and "always" ran away from any differences in opinion they had.  She replied: "Well it seemed that way."

            I asked her to clarify, "Seemed that way or in fact was always that way?"

            She replied, "Well I guess, he's not always that way, but he.."

            "Stop!" I interrupted her. 

            "But he does…" she pushed back.

            "Stop!" I reiterated, "stay with the fact that he's not always that way, in fact there are times when he's doesn't act badly towards you, when he's actually nice to you, isn't that so?"

            I turned to the husband and asked, "And what's the effect of her accusing you of 'always' saying or doing something hurtful to her?"

            "It makes me feel like saying or doing something hurtful to her, but I just shut down before that happens," he explained.

            And so they calmed down, going from being so "thin skinned" about each other to civil and to her making a commitment to refrain from saying "always" or "never" to him and his committing to agreeing to talk to her during conflicts or shortly after he took a needed break to keep from becoming angrier in one of their conversations.

            But they got to that point at the end of nearly every session.  Each one ended with "hope springing eternal." But then hope would not last very long and so they kept coming back every two weeks to receive their emotional chiropractic adjustment to merely maintain their civility.

            Their being so thin skinned and my knowing how much work it would be to help them was causing me to have both performance anxiety –as to whether I could keep them from falling apart completely  -- and anticipatory exhaustion on the toll the session would take on me, before we even met.

            Then I thought, "When I prescribe medication to individual patients, I often rely on how the person makes me feel in their presence in addition to the usual specific symptoms and history that would indicate a psychiatric disorder such as anxiety or depression.  If I felt mentally drained and down from a session that often indicated depression; if I felt edgy, that indicated anxiety. In cases of depression and anxiety I could feel how much effort it took for me to remain centered, non-reactive and calm. 

             "Hmm," I thought, "maybe this couple was suffering from 'depression a deux.'"  That is a play off on the well known psychiatric condition referred to as "folie a deux" (i.e. shared madness), where two individuals craziness played off of each other causing both of them to be even more crazy.  Maybe this couple were depressing each other which was causing each of them to lose the ability to stop taking what each other said or did so personally.  And maybe it was causing her to be irritable and annoyed (often called "depressive equivalents" for being symptoms of depression, treatable by anti-depressants, even though the person with acting that way, would usually not see themselves as depressed) and him to be shut down and avoidant (because depression often makes it difficult to take criticism which then causes you to withdraw to deal with it).

            The distinction between endogenous (internally caused) and exogenous (externally caused) depression had long since gone away in psychiatry. That is because research has shown that rather than people losing a job or relationship causing them to become depressed, it was just as likely that people became depressed first leading them to become more irritable, less resilient and more avoidant, which secondarily caused them to lose that relationship or job.

            Each of these spouses did have a number of the symptoms of depression including impaired sleep and eating, lowered energy, negative mood and feelings of pessimism – which each had been blaming on the other for years.

            Like many patients, neither were keen on the idea of medication, although they both thought the other should be taking them. However when their symptoms and histories were shared with them and how the real "chicken and the egg" situation was that each was probably depressed which made each less capable of dealing with annoyances with the other, they agreed to each try an anti-depressant medication.

            When they returned two weeks later they had only slipped from Defcon 5 to Defcon 4 instead of all the way back to Defcon 1. That was because due to the anti-depressants, they had each developed a thicker skin.  This enabled them to now utilize the insights and keep the commitments they were making from the psychotherapy part of their treatment.  That in turn helped them to develop a thicker skin without developing a cold heart.

10 Habits of Happy Couples    More From Mark Goulston