Interpersonal therapy

Our relationships have a significant influence on our mental health. From an interpersonal therapy (IPT) perspective, the quality of our friendships can either contribute to our sense of security and happiness or become a significant source of distress.  Being friends with friendly, supportive people is not just a matter of preference - it’s a critical factor in maintaining psychological health.

Different types of support: company, practical support and emotional support

When our relationships are good, it can feel like having a safety net beneath you, with several people who can be relied upon to hold it securely should you fall.

Relationships can offer several types of support. The first is simple companionship - being good company, acting like a good book or a film, they may not talk about your distress but can offer a distraction from it.

The second is practical support - doing things such as giving us a lift to the airport, childminding, or watering plants when we’re on holiday. As with all types of support, this is ideally reciprocal – we help our friends and in return they help us – neither feeling exploited nor taken for granted.

The third, most importantly, is the ability to offer emotional support. This means being approachable and willing to listen without judgment. Such relationships offer a sense of safety and comfort, which means that it’s easier to be honest about the way we feel - confident that we will get non-judgemental support and advice. Relationships like this contribute positively to our self-esteem. They acknowledge our strengths, celebrate our successes, offering constructive feedback and encouraging us to grow. There is no competitive edge to emotionally supportive relationships. 

How interpersonal therapy works

Research has long established that emotional support from family, friends, partners and colleagues can act as a buffer against mental health issues, including anxiety and depression. IPT helps in the following ways:

1.Optimising emotional support

When we are surrounded by people who offer encouragement, our capacity to cope with life’s challenges increases. Think of the best teachers you had in school – they understood when you found things difficult and acted as a cheerleader, encouraging multiple attempts until you finally mastered it. Similarly, when we make a mistake at work, it’s more helpful if colleagues contain our anxiety and suggest solutions, reminding us that everyone makes mistakes, than when they judge us negatively and ask how on earth we could have made such a simple mistake.

Interpersonal therapy recognises this dynamic, focusing on the importance of supportive social networks that provide validation, understanding, and constructive help. For everyone, particularly those struggling with anxiety or depression, cultivating friendships based on acceptance and empathy can be a pivotal step toward improving mental health.

2. Increasing awareness of Toxic Relationships
Friendships that are toxic exacerbate feelings of low self-esteem, anxiety, and depression. Toxic relationships often involve dynamics where one person either consistently, or, more confusingly, intermittently, belittles, undermines, or manipulates another. Over time, this creates an environment of insecurity and self-doubt, as we being to question ourselves and take blame for things that are ascribed to us.

Being exposed to judgement, and even criticism unless it’s well framed and constructive can lead to increased stress and feelings of worthlessness. The social climber friend who is lovely to us at times but ditches us at others. The brother who belittles us but, when challenged, quips, “oh you’re so sensitive – I was only joking”. The partner who love bombs us at times, only to threaten us with the silent treatment when we disagree with them or make us feel guilty when we try to assert what we want.

From an IPT perspective, the detrimental impact of toxic relationships is clear. Interpersonal therapy helps individuals recognise these unhealthy patterns and empowers people to make positive changes. This can involve setting boundaries, learning new ways to communicate more effectively, such as by being assertive or, in some cases, ending the toxic relationship. The expression “be friends with the friendly people – they make better friends” is simple: we will feel better if the people around us act like radiators, not drains.

3. Increasing awareness of inconsistency and lack of reciprocity

On some occasions, it’s hard to work out who’s supportive and who is not. Whilst some friends always provide emotional support, others are more inconsistent – at times containing our emotions, and at other times, adding fuel to the fire. They might be good at offering employment advice but catastrophic when it comes to giving advice on romantic relationships, perhaps based on their own negative beliefs and thoughts in this area.

It can be helpful to think of emotional support as being similar to having a physical injury: some people will consistently offer you a plaster; others will dig into the cut, keen to see how sore it is; whilst others can do a mixture of the two, dependent on the situation.

So too, we need to be aware of the importance of reciprocity. If we always offer to childmind for a friend, to take on the extra load at work, or to do all the chores in a flat without getting anything back in return from our flatmates, we will begin to feel undervalued, taken for granted and resentful. If we allow ourselves to be treated as though we’re at the bottom of the heap, we’ll feel it!

IPT focuses on enhancing the quality of our relationships by identifying patterns that may be contributing to emotional distress. Whether it’s improving communication skills, resolving conflicts, or learning to better express emotions, IPT provides tools that can strengthen our social interactions. By applying IPT principles, individuals can develop a clearer understanding of what constitutes a healthy friendship and work towards cultivating positive friendships. It can also allow us to evaluate relationships with family and colleagues, examining how these impact on us and how we can change them for the better.

Conclusion

Having relationships with friendly and supportive people play a crucial role in safeguarding our mental health. While positive relationships boost self-esteem and resilience, toxic friendships can significantly harm our well-being. IPT provides a structured approach to understanding and improving our relationships, enabling us to make better choices in our social lives. In the end, surrounding ourselves with friendly people is not only a wise decision but also vital for our emotional health.