Monthly Archives: November 2012

The Triangle of Conflict

What do we mean by the triangle of conflict? It’s a concept that guides all interventions in ISTDP. So let’s start with our understanding of causality. We understand that a stimulus occurs in life, e.g., a man has an affair, and his wife finds out. In response to that stimulus, she has a feeling (anger). This feeling triggers anxiety in her body. And in response to that feeling and anxiety, the woman uses a defense to ward off her feeling and anxiety. This is important because defenses cause the symptoms and presenting problems patients bring to treatment. In other words, when you diagnose the patient, you will then want to find out what defenses create the symptoms that comprise her diagnosis.

Having clarified causality, let’s look at the triangle of conflict itself: feeling, anxiety, and defense. Let’s take that same woman whose husband had an affair. Suppose you ask her what the feeling is toward her husband. She can respond in only three ways: 1) she can respond with feeling by saying she is angry; 2) she can respond by becoming anxious; or 3) she can respond with a defense, e.g., denial, “I’ve gotten over it.”

If she responds with feeling, we explore feeling. If she responds with excessive anxiety, we regulate anxiety then explore feeling. If she responds with a defense, we help her see and let go of the defense then explore feeling. Notice what the triangle of conflict does for us: 1) it allows us to assess each patient response; 2) it tells us how to intervene; and 3) it tells us which defenses are causing the patient’s presenting problems and symptoms.

Thus, each time a patient responds to your interventions, you psychodiagnose her response: was it feeling, anxiety, or defense? Based on your psychodiagnosis, you know what to address to maintain an effective focus on feeling.

Usually a triangle of conflict is drawn to look like an equilateral triangle. But that is a mistaken image because the triangle of conflict is not static but dynamic. Really, an arrow should point from feeling to anxiety. An arrow should point from anxiety to defense. And an arrow should point from defense to feeling. Why? Because feelings trigger anxiety, anxiety triggers defenses, and defenses repress feelings. The triangle below illustrates this relationship. And the arrows beside the triangle illustrate the two basic movements: defenses repress feelings. Feelings cause anxiety to rise.

Another thing to keep in mind about the triangle of conflict is that it is not a static concept but a living reality, which occurs repeatedly in every session. When we ask the patient what the feeling is toward her husband, feeling rises within her. Within a split second she feels anxiety. We see a sigh. A split second after this, she uses a defense. Thus, moment-by-moment we see the process: feeling, anxiety, defense, one, two, three in that sequence. Thus, we see the triangle of conflict is not just a dynamic relation between feeling, anxiety, and defense, but it is a repeated sequential process that happens dozens, even hundreds, of times in each session.

Sometimes people wonder why we use the term “impulse/feeling” for the bottom of the triangle of conflict. For an answer, we have to turn to emotion research literature. As Ekman’s research showed in Emotions Revealed, there are a handful of basic emotions linked to innate facial expressions universally recognized around the world. Further, Frijda noted that some feelings are linked to adaptive action tendencies. For instance, when sad, we cry. When angry, we form fists and want to lash out. This is why in ISTDP, we invite feelings in three phases. First we ask, “What is the feeling toward your husband for having the affair?” Once the patient can label her feeling of anger, we ask, “How do you experience that anger physically in your body?” Once she can experience her anger physically, we ask, “What is the impulse that goes with that anger?” For the fullest experience of her feelings, we help the patient label her feeling, experience it, and experience the accompanying impulse.

Next: common misconceptions about the triangle of conflict