Interpersonal Role Disputes
An interpersonal dispute is a situation in which the patient and at least one significant other person have nonreciprocal expectations about their relationship. An example is the wife who expects the spouse to take care of her financially but must take an outside job to help meet their bills, whereas the spouse expects his wife to share financial responsibility. Another is the mother who expects her teenage daughter to confide in her fully the details of her friendships, as the mother had with her own mother, while the teenage girl feels that to grow up she must figure some things out on her own. In both examples, the parties have different expectations about the relationship. These expectations conflict--i.e., are nonreciprocal--and hence define a dispute.
The IPT therapist focuses on interpersonal disputes if they seem important in the onset and perpetuation of the depression. This usually occurs when the disputes are stalled or repetitious, leaving little hope for improvement. In such circumstances, depressed patients lose self-esteem, feeling they can no longer control the dispute, and feeling threatened by the loss of what the relationship provides, or incompetent to manage their own lives. Typical features that perpetuate role disputes are the patient's demoralized sense that nothing can be done (that the dispute has reached an impasse), poor habits of communication, or truly irreconcilable differences.
For the therapist to choose role disputes as the focus of IPT, the patient must give evidence of current overt or covert disputes with a significant other.