Meet Robert Taibbi, over 40 years of fixing families and couples

“No family is perfect. We argue, we fight, we even stop talking to each other at times. But in the end, family is family… the love will always be there.”

Meet Robert (Bob) Taibbi, who has over 42 years experience working as a clinical social worker in mental health and therapy. He has published over 300 articles and 10 books and owns a private practice in Charlottesville, Virgina. He’s here to discuss his practice of working with families and couples, and helping them work through the problems they encounter.

It’s time for another interview to share with the Psych2go Community.

1. I got the chance to research your background and I see that you do a lot of therapy. Between family and couple therapy which one do you enjoy more?

I enjoy them both but the process is different for each. As a therapist doing family therapy you are more often in the role of traffic cop — trying to keep the conversation moving, making sure someone isn’t dominating, that everyone has a chance to be heard. Families have their own momentum.

The challenge with couples is balance — there are always 3 people in the room and it is easy for it to feel like 2 against one or one person getting left out or not heard. My job becomes that of maintaining that balance so my the end of the session both partners feel heard.

With both families and couples, I’m not looking for who is the bad guy, who has the problem but rather at the patterns that control the interactions. It is the dysfunctional patterns that we are trying to make the couple and family aware of and change.

2. When a couple has been through therapy, how likely is it that they will go through family therapy again in the future because of the same problems that had occurred in the past?

It depends on how they used therapy in the past and what occurs in the present and future. Many couples and families do not go into long-term therapy to unravel the past or personalities but more to fix specific problems in the present. They treat therapy the way they would go to their doctor. Down the road if another problem comes up with parenting or in-laws, or medical issues, they may come back.

I try to focus on helping couples and families see where and how they get stuck in solving in their own problems so they don’t have to rely on therapy all the time. Here the focus is on creating good communication skills, helping them see what each person is particularly sensitive to so they don’t continue to push their buttons and helping each individual be more flexible — that is do what they have a hard time doing — this is usually about learning to speak up, control their emotions, learning to tolerate confrontation and conflict. If they can do this, their ability to manage everyday problems increases. They may come back into therapy later to have a safe place to talk about something, get help sorting out options, or getting some outside, professional opinions.

3. Is ADHD and ADD the same thing? Are they both a lifelong disorder that someone is born with, or do you develop it?

They are the same thing — officially it is AD/HD — attention deficit hyperactivity disorder. It is someone controversial diagnosis in that while it is estimated to be 5% of US population, in other countries such as France the diagnosis rate is around half percent — why? Culture, child rearing, system of education?

In US we see it as genetically inherited in about 85% of cases (remainder often tied to brain injury) affecting prefrontal lobes and executive functioning and memory capacity. When I was in grad school we thought that kids grew out of it at puberty. We now know that it continues into adulthood though some adults develop better ways of coping with it as they get older. I see a lot of adults in my practice who are undiagnosed or untreated and often come in for anxiety and depression because they are struggling in their lives, have started things and never finished them, are having problems in relationships or on the job.

4. What are the positive and negatives qualities associated with ADHD and ADD (or AD/HD)?

Positives are being spontaneous, energetic, often creative, ability to take risks, often fun to be around. The negatives are the other side of the same things — procrastination, not finishing things, being disorganized, forgetful, seeming to be unreliable to bosses and partners, easily feeling scattered and having trouble focusing on difficult tasks.

5. What is the most serious type of anxiety and what happens if it left untreated? Does it get worse? Can it become life threatening?

I’m not sure there is a most serious type, it depends on level of anxiety. Phobias can be debilitating is you have to encounter your phobia all the time, but not if you don’t. Panic attacks are what upset folks the most because they seem to come out of nowhere, feel terrifying and it sets up the worry that you will have another one, keeping you on edge and creating often a self-fulfilling prophesy. OCD can be debilitating if the compulsions interfere too strongly with everyday life. The problem with most anxiety is that if you listen to your anxious mind those brain circuits get stronger and so does the anxiety. Treatment involves pushing back against it.

6. Sometimes you deal with people who have problems with anger management. Do you believe that is it associated with anxiety as well as the desire to start arguments?

Many of the people I have met with anger issues do seem to be anxious — they are often hypervigilant because of past trauma, abuse, post-traumatic stress. They are over sensitive to their environment and quickly go into “fight mode”. I also see that they tend to not be emotionally flexible — that is, they have trouble distinguishing other softer emotions like worry, hurt. Instead everything gets translated into anger.

7. Can someone be angry and wanting to start arguments all the time? Do you see people with anger issues continue an argue without any reasoning behind it?

Those who are hypervigilant can seem angry all the time. What happens for most of us is when we get angry our amagdela, our emotional center, shuts down our prefrontal lobes, our rational brain goes offline and we get tunnel vision. We want to win the argument, make our point. This is where I see couples starting to stack up evidence from the past to make their case. The problem is no one literally has a rational brain at this point and can’t process what the other person is saying. The facts and stories are fueling the underlying emotion. It’s the fire of the emotion they need to put out by calming down.

8. When dealing with mental health cases, which mental problems have been the toughest to work through? Do you work with bipolar and psychosis disorders as well?

I have not worked much with people with psychosis or bipolar — now much of that is managed through medication and therapy involves helping folks manage stressors and having the supports they need to stay stable. Trauma can be difficult and our approach to trauma has been changing as we learn more about the effects of trauma on the brain. Addictions can be difficult to treat depending on the tenacity of the addiction and the type. Eating disorders, especially anorexia, are difficult. Anorexia in particular is difficult to treat and also the literally the deadliest — it has the highest rates of deaths due heart attacks and other body breakdown.

If you have any questions for Robert, feel free to visit his website at http://bobtaibbi.com