Archive for anxiety

Couple Therapy can help with Mental Health Issues

Mental Health Awareness week takes place from 8-14 May and this year’s theme is ‘Surviving or Thriving’. Since 2005 mental health problems are on the rise – we are making progress on our physical health but not doing the same with our mental health. Thanks to journalists and TV programmes speaking out against the stigma of mental health, our awareness is being heightened as to the effects of mental health issues on daily lives. Thanks to Prince Harry leading the charge of his own experience of depression and anxiety and his work with the Heads Together Campaign with The Duke and Duchess of Cambridge they have highlighted the importance and power of conversation and how being able to talk openly about mental health challenges can be life changing. It now seems a good time to think about how mental health issues impact on our couple relationships.

Mental Health Professionals tend to focus on symptoms and treatments with the individual and overlook the huge impact this has on our couple relationships. Any couple relationship can have its proverbial ups and downs but what about when there is the extra challenge of being the partner of someone who has a mental illness. Losing harmony and connection in a relationship is difficult enough but especially so if some of the relationship changes are brought about by one or both partners developing mental health issues. Things can be very challenging for a partner without mental illness who has to assume a care giving role

Most people fall in love because they are enjoying each other’s company, have fun together and live harmoniously. Life doesn’t always work out as planned. When a partner becomes depressed, they often tune out, withdraw and have little energy to do much except sleep. This can often give the impression to a partner that they are no longer cared about, and there is no interest in them, or going out or having sex. This often leaves the other partner having to pick up the slack especially if there are children. As frustration and exhaustion develop over time, this often turns to anger and resentment at a partner who cant seem to “get over ‘ the depression. If this pattern continues it can often lead to affairs and a complete breakdown of the relationship.

Issues with mental health can be debilitating and its important that partners recognise some of the signs that suggest a partner is suffering:
signs to look out for:
withdrawal
agitation
hopelessness
acute tiredness
poor self care
change in personality

In my work with couples I see how a healthy relationship can serve as a buffer to help ward off mental health conditions. Equally it is well documented that relationship stress can negatively affect the person who is struggling with mental illness and make the condition worse.

We all come to our adult relationships with conscious and unconscious patterns from our own experiences and feelings around mental health. For example growing up with a parent or family member who may have been depressed, anxious or suicidal can greatly influence how we manage mental health issues in our current partnerships.

Couples coping with some mental health issues are not that different from other couples in therapy. Often individuals experienced a difficult childhood, a history of low self esteem and lack of confidence, trauma and loss. Although many of these things happened in the past, they often find a way of infiltrating the couple relationship resulting in on-going conflict. They too develop patterns of poor communication, increased conflict and loss of intimacy. They too have got stuck in negative cycles leaving them feeling distant, helpless and sad.

Give therapy a try

Coming to Couples Therapy with your partner is a positive step forward. Every Mental Health issue presents its own unique challenge and can be complicated and testing on our relationships. It requires special attention in couples therapy from a skilled couples therapist to help give clarity to the situation.

Finding a qualified couples therapist is a valuable option to help explore the roots of the mental health issues and to try and understand how it affects each partner. At Coupleworks we pride ourselves in taking care to consult with the patients GP, primary care worker or psychiatrist so that we can all work together for the patient to bring about change. We don’t have to just Survive we can learn to Thrive.

Dawn Kaffel

Issues of Anxiety and Control in a Relationship

Couples in a close loving relationship often describe trusting that the partnership is an emotional safe haven. They feel optimistic for the future of the relationship because they hold the belief that their partner is looking out for them, has their well-being at heart and wants the best for them. The relationship feels a refuge from life’s pressures, and a support when facing the vagaries and stresses of the modern day world. They can relax with the understanding they are loved and accepted, they have someone to turn to, and their partner is someone they can lean in on when things are difficult. The couple feel ‘more than’ when together and relish the idea that the ‘whole is greater than the sum of the parts’.

Which is why an affair can have such a devastating impact. The security has been breached and the relationship suddenly feels adrift, shaky and fragile.

However, our individual psychological insecurities can also wreak havoc on a relationship. Extrapolating from past painful experiences we become pessimistic and make negative predictions about the future. We assume that similar situations are bound to happen again.

A man would not get married on his birthday because it would mean that day would always be spoilt after they divorced. A previous girlfriend had let him down badly and he was predicting the end of this one even as he planned the wedding: ‘It’s the kind of thing that always happens to me.’
Childhood hurts can diminish our willingness to trust and so foster a dependency on overt displays of reassurance and expressions of certainty. However, constant requests for minute detail, concrete evidence, and proof of fidelity, can become oppressive and destructive.

The rationale can be that ‘I too felt unwanted when my father had an affair and left my mother. I believe all men to be somewhat untrustworthy and I need to be on the alert so that I’ll not be abandoned and rejected again’.

A woman had become hyper-vigilant and, despite his loving behaviour, was secretly checking her partner’s phone for possible proof of an affair. When he found out he was distressed and angry at what he felt was an attack on his integrity.

Open wounds from a previous relationship can colour the view of a present partner and suspicions about their sincerity, openness and honesty can breed. The joke ‘The figments of my imagination are out to get me’ no longer feels funny, and a runaway imagination becomes a primary source of stress. Fear is a response to the perception of an immediate threat, while anxiety is a response to a possible future threat. Both states mean the brain moves into ‘Fight, Flight, Freeze’ mode and releases high levels of adrenaline and cortisol with tension and agitation manifest in the body.

Attempting to avoid the possibility of more pain and hurt we work hard to keep ourselves safe, expending huge energy on being super-vigilant, well-informed, and in as much control of the situation as possible. To relax and trust feels counter-intuitive: ‘Why would I? It’s a dangerous world.’

And yet, ‘I’ve had a lot of worries in my life, most of which never happened’ (Mark Twain). We need to beware of creating a self-fulfilling prophecy. There is a danger that the compulsion to avoid the imagined catastrophe can become obsessive and addictive and a chronic need for reassurance, being in control, can take hold. The attempt to manage the anxiety then becomes counter-productive when it causes distress and hostility as a partner resists the control and rails against being accused and blamed

Unchecked, anxious responses to uncertainty and states of not-knowing can create poisonous feelings of dread, panic, jealousy and anger. All are toxic to a happy relationship which needs a dynamic of acceptance, trust, contentedness.

You might find it interesting to listen to a (long!) lecture by Martin L Rossman on ‘How Your Brain Can Turn Anxiety Into Calmness’ and pay particular attention to the visual imagery exercise at the end.

Kathy Rees

Blame or Acceptance and Understanding in a Relationship

Zen master Buddhist, Thic Nhat Hanh, writes:

When a plant does not grow well, you do not blame the plant. You look for the reasons that it is not doing well. You may need to do something differently: it may need feeding, or more water, or less sun – but you don’t blame the plant.

Yet, very often, if we have problems with our family, or with our partner, or with friends, we blame the person. Frequently, however, the blame has little positive outcome. It rarely results in the desired change in behaviour, or attitude, or belief and, more often, prevents the possibility of dialogue and discussion. At worst, a blaming culture in a relationship has a corrosive and destructive effect. We all know the feelings of frustration and resentment that arise when we feel misunderstood and unfairly blamed and we can become closed-off and angry.

The counsellors in Coupleworks often work with couples to learn the most effective ways to take care of their particular relationship so that it can ‘grow well’ and thrive. Sometimes a couple can get stuck in a culture of blame – and each partner needs to understand their own role in that dynamic and what they need to do differently. Why are they stuck with feeling that the other is not good enough or, somehow, should not be the way they are? Each needs to reflect on this anxiety and their urge to criticise and attack. How can each take responsibility for getting needs met with compassion and generosity, and what has to happen if they are both to make the choice to ‘tend’ and not diminish?

Of course we can be upset and distressed when our idea of what reality should be confronts a different reality understood by our partner. But a conflict in a relationship is a couple problem that needs both parties collaborating to resolve. Alienating one another prevents a shared creative thinking.

If a relationship is to flourish and deepen it needs to feel safe – and acceptance and understanding is fundamental. Acceptance does not mean approval, consent, permission, agreement, aiding, abetting or even liking what is. But it does require each partner seeing the other and accepting ‘That’s the way it is’ and ‘That’s the way they see it’.

As a therapist I am alert to when a couple begins to talk in absolutes: ‘You always…’, ‘You never…’ and when perceptions are filtered through ‘should’s, must’s, and ought’s. An insistence on wrong-doing, of being ‘right’ or wrong’, then requires a respectful exploration of value-systems, perceptions, and beliefs.

A challenge to our expectations can make us anxious and rigid and there is a danger that love can then become conditional: ‘I’ll love you if you are different’. The need to ‘walk a mile in your shoes’ to find understanding then becomes more critical than ever.

Kathy Rees

Summer Holidays and How to Survive Them

It’s no coincidence that couple therapists get a wave of phone calls before and after the summer holiday season. Anxiety levels increase and tempers flare just planning the holiday. We often find ourselves overloaded with work and commitments, leaving us exhausted before we even step on to the plane or into our cars. So how can we prepare to turn our holiday expectations into realistic ones, which will leave us feeling relaxed and enriched.

We spend the winter thinking about our summer holiday: where shall we go, where shall we stay, what will we do? We dream of how relaxing it will be and how much fun we are going to have. Yet, the reality can be very different. Spending time with our other half every minute of every day is often challenging and can sometimes be more than disappointing.

Groundwork:
Deciding with your partner where to go starts with being clear about the kind of holiday you want. If you want a city holiday and your partner wants a beach holiday, for instance, there is no point in giving in, it will only cause resentment. Don’t be a martyr. Negotiate and compromise and see your partner’s point of view, this will give you both the opportunity to get at least some of the holiday you’re looking for.

Slow down:
Take care to slow down before leaving. Have early nights, that proposal can wait until morning. Eat well and exercise regularly to keep balanced. Don’t over commit with friends or take on extra work just before your trip. It will only stress you out.

Details:
Spontaneity is not helpful when travelling. The better prepared you are the more seamless and less anxious your experience will be. Do your research: Book reasonable times to depart and arrive at your destination so you are relaxed not exhausted. Don’t take that 5.45am flight to Istanbul or arrive bang in the middle of a New York rush hour. Doing packing at the last minute while searching for misplaced travel documents are also not recommended. Being well organized helps to lower stress levels and allows us to start our holiday on an even keel.

Your Trip:
Remember, this is an opportunity to let go and spend time with each other without the pressures of work and daily commitments. It’s also a time when things that need to be addressed and have been ignored tend to come out between couple. Agree to limit your discussion to issues that aren’t historically explosive and only when you haven’t been drinking.
Turn off your phone and IPad when together and agree to be present with one another and listen to your partner. This is a great opportunity to remember why you fell in love with them in the first place.

Hopefully, now you won’t come home from your holiday needing another one to recover from it! Have a wonderful trip.

Shirlee Kay

 

Moving house can be a positive step for a relationship

Statistics tell us that moving house can be one of the most stressful experiences alongside divorce and bereavement. Certainly at Coupleworks we often see clients who are facing a move into a different area or who may be considering relocating to a different country. This is often where communication breaks down and can be seen as a negative experience. This can raise unresolved issues between a couple at a crucial time of change and interferes with the feelings of joy and connection with starting somewhere new.

Having just been through the experience of moving out of a home shared for 32 years with a partner who has always been very reluctant to move, I appreciate how stressful it can be especially as we only had 4 weeks to do it in, which in our case probably was the best thing, as there wasn’t much time to process anything except start packing!!

I was rather anxious how we would cope knowing that moving house can put a strain on even the most solid of relationships. Here are some of the thoughts I had along the journey:

Moving house can be an incredible rollercoaster. Change can be scary for one and exciting for the other. Home was always comfortable and familiar. Going someplace else is new and very unfamiliar. Despite the stress and tensions, it is surprising how beneficial it can be if treated in the right way and if we take advantage of opportunities open to us. Managed well, far from straining a relationship, it can often strengthen it and breathe new life into it.

Here are a few tips to help reduce anxiety and ensure your move progresses as smoothly as possible.

• Delegation of responsibilities. You know what your strengths and weaknesses are. Discuss and work out who is going to do what and when and keep check lists.
• Discuss what you need to take with you, what you need to leave, what you need to dispose of and what you may wish to give to charity
• Give yourselves time to talk about the things you might miss about your old home. Remember the happy and sad times spent there, the neighbours, the familiarity, the views. Acknowledging all the losses and expressing sadness is a positive step
• Don’t be afraid to express your fears of the unknown – the what if’s…
Moving from where you know to where you don’t can bring on anxiety for most people. However change can be very exciting and can bring new life to a relationship so go and grab it and make the most of it.

Counsellors at Coupleworks specialise in helping clients resolve any difficulties that might make moving house easier to manage. This can be via face to face, telephone, or if you don’t have time to attend in person through our Skype counselling service. Please do contact us at Coupleworks

Dawn Kaffel

Managing a Disagreement

Within a relationship there is the reassurance of feeling that there is someone with whom we can share life’s difficulties and satisfactions. It is consoling to think that there is a person who understands and on whom we can lean. There is a comfort in knowing a partner has the same values, shares the same outlook and interests, and has a familiar perspective on the world. The similarities are affirming and help us relax and feel trust. Even differences can be perceived as offering an opportunity to widen our horizons.
However, there are some differences which create a frisson of panic and appear to us to attack the secure base of the relationship. A certain difference of opinion seems to be the polar opposite of our own and we feel vulnerable and insecure – perhaps not taken into account. We make interpretations that, if s/he thinks that, or can do that, perhaps they are not the safe pair of hands that was imagined. Maybe s/he should not be trusted. Maybe s/he does not love as much as was hoped.
When this anxiety grips there is an unconscious rationalisation that a fault-line in the relationship has been revealed. Linked to the strength (or the precariousness) of the attachments in our childhoods, a fear of abandonment can be evoked. It leads us to be defensive and either withdraw or protest. We defend against the loss of the loved relationship – while making the loss dangerously possible. An angry exchange can quickly escalate into a bitter argument. Paradoxically, the fight is an attempt to reconnect and regain concordance. We are trying to deny, disprove, attack an opposing view and re-establish the cocoon of unity.
As an alternative, wonder why your own reaction is so strong. Are you overlaying a past experience onto the present? Don’t jump in too quickly. Avoid starting a sentence with ‘Yes, but…’ and LISTEN instead of contradicting. Try to be curious instead of dismissive. Without feeling you have to concede your own position, ask for more information. What is the underlying story? Wonder about the FEELINGS as much as the facts. Ask for time to give your own explanation. This should not be about attacking your partner but should be focussed on yourself. Use ‘I’ not ‘you’. Avoid finger-pointing and global statements that stress ‘always’ and ‘never’.
Find the common ground, even if it is just agreeing that there is an unresolved issue, and join forces as a couple to solve the problem. Brainstorm and ask for possible solutions and alternative suggestions. There may be room for small concessions on both sides. It is not about scorekeeping or tit-for-tat. See yourselves as collaborators once more.

Dealing with Tension – A Quick Fix!

How often do you pour that glass of wine, or reach for the chocolate, or slump in front of the television, to try to switch off from the day’s problems and stress?

The relief may not last but, for a short while, you feel better. However, it may be that those choices are not so good for you in the long run.

It could be that taking a break from the computer screen, or going for a walk, or not drinking too much the night before, might prevent a headache. But, when our head begins to throb, we take a pill because we want rid of it quickly.

Similarly, although we need to address the causes of our difficulties, it is helpful to have a ‘quick fix’ to find short-term relief from tension and anxiety and feel, momentarily, emotionally stronger.

If you are feeling overwhelmed, or anxious thoughts are preventing you sleeping, then try shifting the focus from head to body and consider how you are breathing.

The way we breathe has a huge impact on the way we feel. Too often we are in perpetual ‘flight/fight’ mode and ‘shallow breathe’ with rapid breaths.

  • – If you are in work, go into a quiet room and straighten, standing against a wall. If you are at home, lie flat. Close your eyes and place your hands gently on your abdomen.
  • – Slowly take in a deep breath through your nostrils until you feel your abdomen begin to rise. Do not lift your shoulders or puff out your chest.
  • – Hold for a second.
  • – Slowly breathe out through your mouth feeling your abdomen fall.
  • – Repeat ten times.

You are opening up your lungs, expelling the stale air, and easing the muscular tensions around your stomach and ribs.

Consciously relax your jaw and your shoulders. Be aware of the muscles holding the tension and try to make them floppy.

The effect should be that the amygdala in your brain is reassured that all is well. It can halt the release of adrenalin and cortisol that keeps you hyped-up and tense.

Short-term relief perhaps, but a moment of calm allows a moment of recovery. We reconnect with the resilience required to face the challenges of work, family, and relationships.

(With grateful thanks to ‘The Big Book of Calm’ by Paul Wilson)

 

Mindfulness and sexuality

The brain is one of the key factors that contributes to a good sexual experience.  It can either help us or hinder us.  We can often have distracting thoughts  – a shopping list or work, or thoughts about our bodies or the need to perform.  To have better sex we need to allow ourselves to be actually there when we have it, letting go of what is going on in our heads.

Mindfulness is about self regulating your attention to become aware of your immediate experience and allowing that experience to be what it is, with acceptance and without judgment.

The benefits of practising mindfulness can include:

  •  Increased awareness of physical sensations
  •  Managing and reducing anxiety
  •  Change towards positive body perceptions
  •  Deepening of life experiences
  •  More connection and intimacy in partner relationships

The practice of mindfulness can be used to enhance sex, and is often used as a specific tool in treating various sexual difficulties.

 

The Challenges in finding a Healthy Work/Life Balance: Work

ONE:  When we focus on work…

  • • We can often prioritise the demands made by work over the demands emanating from relationships. There can be a disproportionate focus on job over family.
  • • The requirements of the job seem more straightforward, more clearly defined and more easily understood. We list the assignments and achieve the deadlines and, as a result, receive a reassuring sense of competency. There can be a satisfying confirmation of our identity and role in the world.
  • • Feeling in control, being task-orientated, receiving positive feedback from colleagues, can stave off a susceptibility to insecurity and anxiety.
  • • Work can increase our confidence and self-esteem, and soothe a fear of failure; particularly if we have a tendency to feel ‘not-good-enough’
  • • In addition, the time and energy expended is difficult for a partner to challenge when it is justified in terms of earning money and developing a career.