Archive for therapy

Understanding Changes in Sexual Frequency

Many couples we see at Coupleworks come into therapy feeling as though there is something fundamentally wrong with their relationship when their desire starts to wane and the pattern of their sex life changes. It can sometimes be difficult to help couples normalise these feelings and avoid getting caught in an internal narrative that if their sex lives slows down the relationship is no longer viable.

When couples come to therapy, it is usually because the difficulty has gone underground and been around for quite some time. There is a tendency not to address sexual issues with one another (it’s uncomfortable and awkward), and the gap tends to widen to a point where it is difficult to see a solution. Couples seem able to talk about ‘the fact they aren’t having sex as often’ but less able to talk about their feelings of hurt and rejection. In my mind, it’s when couples bury their feelings that toxic thoughts start to surface between them. Couples usually begin to feel a sense of relief after the initial discomfort of actually starting the conversation.

Common reasons why couple’s sex lives change:
Work
Pregnancy
Children
Stress
Tiredness
Illness
Depression
Tension between Couples
Outside Factors

As couples get caught up in their daily lives, the attention towards their partner changes and a pattern begins between them. The key is to name the issues and more importantly tell the other how they experience these changes. I had a woman tell her husband in a session that his lack of desire for her brought up strong feelings that the relationship was over. These feelings triggered memories of her father leaving her mother for a younger woman. Her internal narrative didn’t allow her to be curious about what might be going on with her husband or the relationship and allow her to address the issue with him. As we worked through this, she discovered he was overstressed and exhausted, and we found ways to help him lower his stress levels and find his way back sexually to her. Disentangling these stories helps couples see one another separately and not personalise the experience. With this couple, it helped them to see that there were external factors contributing to the man’s change in desire and allowed them to find ways of addressing them.

What Couples Can do to Reconnect Sexually:
-Name the Issue.
-Tell each other how they experience it.
-Take time to spend more time with one another.
-Make physical connect with one another on a daily basis.
-Make eye contact.
-Kiss each other.
-Be present when speaking to one another.
-Touch one other regularly even when not having sex.
-Express your appreciation of the other often.
-Do special things for each other.
-Explore others ways of being intimate (sex is a way but not the only way).
-See a psycho-sexually trained therapist.

Long-term relationships naturally change and evolve. Accepting these changes and keeping an open dialogue is key to a couple’s intimacy. When they can see that their sex life is unique to them and not be influenced by what they ‘should be doing’ they are better able to understand what works for them. Being open and honest about these issues helps to generate a conversation. It’s not always about finding a definitive answer but more about understanding and living with the issue differently.

Shirlee Kay

Couples and Marriage

Over the next few weeks thousands of weddings, both of heterosexual and same sex couples, will be taking place up and down the country. The summer has been the most popular time to get married for many decades and with the British weather, that’s unlikely to change.

But what has changed is how people view their wedding day. Until around the 1970’s what was widely held to be the norm was that marriage provided the gateway to the whole experience of living together and sharing a single home. But the large majority of couples today have already been living together for some years before they tie the knot. So what is it that they see themselves doing? In my experience, most couples feel they have reached a point where they can take the risk of declaring to themselves and to others that they wish to be married. Of course other factors can be in play. They may want to provide what they see as a more secure base to have children. Sometimes too there is a hope that marriage will resolve problems in a relationship that already exist. But for most, getting married is a statement that their relationship is now sufficiently permanent to celebrate and give ongoing stability to.

They also think that the ceremony itself won’t make any difference to their day-to-day relationship and are often surprised to find tensions and difficulties surfacing. The reasons for this are often complex. For some making the public commitment proves to be profoundly unsettling, triggering memories and unconscious feelings of their own family experiences. The net result is that they are taken aback that at the point when they announce stability they feel de-stablised.

Therapy offers a place to talk through expectations, to explore and understand what might have been triggered and to work through these disappointments. This gives couples the opportunity they need to confront the reality that there is no end point to growth in a relationship but they will need to continue to work together on it throughout their lives.

Couples can begin to explore possible difficulties by talking through:

• Expectations of what marriage means

• How that is different in your mind – or not – from co-habiting

• What your experience was as a child of your parent’s marriage

• How would you like yours to be similar or different

 

Sarah Fletcher

Siblings at War

Sibling Rivaly. It can all sound a bit Freudian and irrelevant within modern couple difficulties.
But remember, this is where most of us start to investigate our relationship powers.
The first group most people encounter is within our original family and each new child hopes for the starring role. However, the disappointments of displacement can come all too fast as another, rival baby enters the home.
Sometimes there is already a co-star in the shape of a demanding toddler born before us who will be fighting for autonomy. Each child struggles for top billing – with their parents as audience.
As a beloved new baby, getting toppled from that important pedestal means that you are no longer getting all that precious attention, so sibling rivalry can be bitter. And for most children any displacement will feel too early.
As relationship therapists, we see this often. Many couples will mirror each other with similar positions in their early family structure.  When people’s feelings run high, the bickering can degenerate into playground style squabbling. Each trying to show who is the most hard done by, and the most wronged partner.
Conflicts like this often cover up the real issue which is fear. Couples can disagree on fundamental issues but the scary things is to trust that a partner will still love and respect us and our views even if they aren’t shared. Therapy can provide that safe space to reflect and really listen to a partner. We don’t have to agree with all their ideas and beliefs, but we do need to listen and better understand each other.
Sibling rivalry is based on injustice – real or imagined. Most of us struggle for feelings of fairness in couple relationships. If the other thinks we are wrong they are inferring we must be to blame. So we retaliate, insisting that they are wrong and so it goes. Except that sometimes nobody holds the golden ticket. Things can just be different for each of us.
When filled with frustration and rage, try to imagine where you may have experienced a similar struggle back in childhood. That’s often where it all begins.
Keep your friends close, and your enemies closer. That brother or sister knows where all the skeletons lie within the family cupboard and can be a close ally as time goes on.
They know you well, and that can be a scary thing. But they can also be a deep support for life.

Christina Fraser

Counselling? NHS or Private?

The Differences Between the services offered on the NHS and by a Private Practice.

Clients are often in two minds about seeing a counsellor/psychotherapist in the NHS and seeing one who works in private practice.

The Pros and Cons of going NHS
Pros:
-Most importantly, there is NO cost involved.
-The therapist is trained and should be accredited (always check).
-The therapist will be provided with supervision to ensure that their clinical work is being overseen.
Cons:
-There is no choice in the therapist you see.
– There is little choice in the geographic location of the therapist.
-There is no choice in how long you are able to work with them.
-There is no choice in the approach of therapy you receive (CBT, psycho-dynamic, etc).
-There is little or no flexibility in scheduling.
-Your GP is the first step to being referred to an NHS therapist. Depending on where you live and the severity of the issues there may be a wait in getting your first appointment and you may be assessed first with another therapist or psychiatrist.
-Your medical records will note the referral.

The NHS website states the following regarding what they offer:
-Face to face Counselling
-Individually or in a group
-Over the Phone
-By email
-Using a specialized computer program
-You may be offered counseling as a single session, as a course of session over a few weeks or months or as a longer course that lasts several months or years.

The Pros and Cons of going Privately
Pros:
-There is a choice of therapist.
-Choice of times offered outside of the normal working hours, (evening and weekend appointments)
-Choice of length of the therapy (short term/long term)
-Choice of therapy (psychodynamic, CBT, couples therapy. The list is vast and diverse).

-Therapists are required to have supervision and further personal development and are insured and (should be) accredited under the BACP or UKCP.
Cons:
EXPENSE, there is a charge, which varies depending on the therapist.

In conclusion, there are pros and cons to both private and NHS counseling services. The main differences are the choice and expense. Choosing to go privately allows more of a bespoke service and works better for many people’s lifestyle.
When choosing to go privately, you are paying for a better environment to work in and more flexibility with times and whom you see.

It should be pointed out that there is a third alternative for those seeking therapy. There are several non-profit organisations out there that offer much lower fees with trained therapists for those financially unavailable to see a private therapist but wish for an alternative to the NHS. The services provided have their drawbacks as does going private or through the NHS, but that’s an article for another time!
Finally, please remember one thing: whether you choose to go NHS or Privately, the service should meet your requirements. It’s important to speak out if the service offered isn’t up to your expectations or needs.

Shirlee Kay