Rules you really dont know for happy marriage. By Lukonge Achilees

1.Respectfulness is oftentimes more important than communication — if your partner doesn’t want to talk, give them the space they need
2. When someone is wrong, don’t keep score
3. “Love your partner the way they need to be loved, not the way you need to be loved” (and take the time to understand Respectfulness is oftentimes more important than communication — if your partner doesn’t want to talk, give them the space they need
2. When someone is wrong, don’t keep score
3. “Love your partner the way they need to be loved, not the way you need to be loved” (and take the time to understand what that means)
4. Don’t punish your spouse for being honest — you won’t always like what they have to say, but punishing them for it will ruin your future communication
5. There’s no such thing as “winning” an argument — if you can’t come to an agreement that satisfies everyone, you’ve both lost
6. You’ll see each other at your grossest, like when you’re vomiting or have diarrhea — don’t use it to humiliate each other later on
7. Be the kind of spouse you would like to have by your side
8. Don’t correct the other person unless it’s important
9. Never hold money against each other
10. Similarly, never make a big purchase without talking to the other
11. Always keep an extra blanket by the bed, just in case you have trouble sharing one night
12. If one person voluntarily cleans something, the other shouldn’t complain about how it was done
13. Give each other alone time, even if you aren’t fighting
14. Never disrespect your partner — not in public, not in front of your friends, and definitely not to your kids
15. 50-5o doesn’t exist, so expect something closer to 60-40 — who gets what will change from time to time
16. Never, ever bring up divorce, even in a joking way — pretend it’s not an option, like doesn’t even exist
17. Cultivate separate interests and encourage one another to pursue them
18. If you have kids, it’s okay to put your spouse first — a healthy marriage will ultimately benefit them
19. Learn to know when you fucked up and apologize sincerely without adding a “but…”
20. Make these rules spoken that means)
4. Don’t punish your spouse for being honest — you won’t always like what they have to say, but punishing them for it will ruin your future communication
5. There’s no such thing as “winning” an argument — if you can’t come to an agreement that satisfies everyone, you’ve both lost
6. You’ll see each other at your grossest, like when you’re vomiting or have diarrhea — don’t use it to humiliate each other later on
7. Be the kind of spouse you would like to have by your side
8. Don’t correct the other person unless it’s important
9. Never hold money against each other
10. Similarly, never make a big purchase without talking to the other
11. Always keep an extra blanket by the bed, just in case you have trouble sharing one night
12. If one person voluntarily cleans something, the other shouldn’t complain about how it was done
13. Give each other alone time, even if you aren’t fighting
14. Never disrespect your partner — not in public, not in front of your friends, and definitely not to your kids
15. 50-5o doesn’t exist, so expect something closer to 60-40 — who gets what will change from time to time
16. Never, ever bring up divorce, even in a joking way — pretend it’s not an option, like doesn’t even exist
17. Cultivate separate interests and encourage one another to pursue them
18. If you have kids, it’s okay to put your spouse first — a healthy marriage will ultimately benefit them
19. Learn to know when you fucked up and apologize sincerely without adding a “but…”
20. Make these rules spoken

Advertisements

How healthy your relationship is? you should know these questions. By Lukonge Achilees

Romantic relationships are about attachment. We need from our partner all the same things we need from a parent when we’re children: assurance that they won’t abandon us, demonstration that they care, reason to trust them, etc. The more you foster this attachment, the healthier your relationship will be. The weaker this attachment, the unhappier and more likely to break up you will be.

1. Do you use a “soft startup” to bring up difficult topics?

One of the strongest predictors of divorce in Dr. John Gottman’s empirical research on marriage was a “harsh startup” to fights. “You don’t care about me!” “You never take out the trash!” “There you go again, going into la la land.” Instead, use a startup that doesn’t attack your significant other. “I’m not feeling happy with the way we’re dealing with the garbage right now.

2. Do you criticize or show contempt for your spouse?

Criticism means, when you bring up issues, you attack them as a person, rather than raise complaints about actions or situations. Contempt means you’re disgusted by them. These usually take the form of superlatives. “You’re lazy. That’s why you don’t help me.” “You’re a cold bitch. Why can’t you ever consider my feelings?”

3. Are you defensive?

When our significant other brings up an issue, do we immediately try to justify our actions? Do we defend ourselves? This is natural if they’re criticizing us, but even when that’s the case, defensiveness escalates the situation, rather than defusing it. If even when they’re aggressive, you can ask “what’s wrong?” instead of “no I don’t!” you dramatically reduce your odds of divorce.

4. Do you make repair attempts?

Repair attempts are anything that de-escalates a fight. It can be an apology, a hug, or a comment. “We’re getting heated. Let’s slow down.”

5. Do you recognize your partner’s repair attempts?

Even more important than making your own repair attempts is accepting your partner’s. If they reach out to you to de-escalate tension, and you ignore them, or attack them, this was the single strongest predictor of divorce in Gottman’s research.

6. Do you know your partner?

What’s your partner’s favorite food? What’s troubling him or her right now? What is he or she trying to achieve? You should know these things off the top of your head. If you don’t, you need to talk to them more.

7. Do you make frequent small gestures of love?

Relationships don’t live on grand gestures. The big fight you had won’t kill your relationship, and the trip to the Bahamas won’t save it. It’s when you hold each other when you get home from work, or you cook for each other, or you remember their birthday. These are the moments that reinforce your attachment every day.

8. Do you pay attention to them?

Just as it’s the small things that build attachment, the small things destroy it. If they come home upset, and you don’t do anything to comfort them, they will feel abandoned, and this will chip away at your relationship. Your moments of ignorance do more to wreck your relationship than anything else, and fights are usually a consequence of feeling abandoned, not the true cause of relationship meltdown.

9. Do you use “I” statements?

A habit of highly successful couples originally proposed in the ’60s by Dr. Thomas Gordon is to speak in terms of “I” rather than “you.” This keeps you talking about facts. “I feel XYZ,” as opposed to “you are doing ABC.” It avoids the criticism and contempt mentioned before.

10. Do you let them influence you?

The more hierarchical your relationship is, the more likely it is to fail. If you are unwilling to consider your significant other’s perspective on things, and everything must be done your way or the highway, there’s a high chance it will lead to the highway.

11. Do you practice loving rituals?

We are what we make habits. If you make a habit out of rituals of love, you will consistently reinforce your relationship without thinking about it. This could be a date night every Friday, a daily cuddle session, or an annual honeymoon. All of the above are good ideas.

12. Do you practice “loving jealousy?”

It’s popular to believe that jealousy is a sign of love and affection. It’s actually a sign of distrust and insecurity. If you’re not comfortable with your lover visiting friends, talking to the opposite sex, or doing anything in general, your relationship will be more miserable.

13. Do you hold your lover responsible for your emotions?

As I mentioned, it’s important to be sensitive and attentive to your partner, but you can’t hold them responsible for taking care of your feelings. You need to take measures to comfort yourself and manage your own emotions too. They are only human. It also helps if, when you need their help, you verbalize that need.

14. Do you continue to improve yourself?

It’s easy to get complacent in a relationship, and most people do. It’s a tendency you need to resist. Keep going to the gym. Keep developing hobbies. Keep making yourself sexier and more interesting.

15. Do you turn towards them?

One of the strongest indicators of successful couples is “turning towards” rather than “turning away.” Individuals in couples often make “bids” for each other’s attention. This can be everything from calling to ask if you need milk to commenting on the pretty bird. The milk and the bird aren’t important. Responding to your lover is. Couples that respond to their lovers’ bids for attention are immensely more likely to stay together years later than those who don’t.

16. Do you deal with your solvable problems?

Most problems in relationships are solvable. They might be big arguments, but they can be resolved through compromise and sensitivity. Couples who sweep these problems under the rug (usually because they use harsh startups and are critical of each other, making talking about problems uncomfortable) grow bitter and miserable.

17. Do you have a system for accommodating your unsolvable problems?

Unsolvable problems derive from differences in core values or dreams. They might involve religious differences, disagreement about kids, differences in desire to travel, etc. These aren’t the deal-breakers we often assume them to be (though they can be). Couples who successfully address unsolvable problems employ habits that minimize the influence these problems have on their relationship.

18. Do you admire your partner?

Partners who admire each other are far more likely to happily stay together. Get in the habit of reminding yourself about your partner’s positive qualities. Remember why you fell in love with them.

19. Are you willing to leave?

Ending the relationship should be the last resort, but it has to be an option. If you are addicted to your partner, or are too insecure to live without their validation no matter how bad the relationship gets, this can kill both of your motivations to work on the problems.

20. Do you keep score?

Some couples think successful relationships are about reciprocity. “He does things for me, I do things for him.” The good things you do for each other should arise because you want to do them, not because you expect reciprocity. You also should be forgetting the missteps, not saving them to bring up in the next fight. If you’re keeping an account of who’s investing more or less, this is a sign of a broken relationship.

50 Powerful Reminders From Actual Therapists To Encourage Your Personal Growth

1. Imagine you are standing at a train platform and unhelpful thoughts are the trains that pass, you don’t need to get on every train, acknowledge them and let them pass.

2. Before you spend your time and energy solving a problem, make sure it’s your problem.

3. Stop expecting to find closure. There are times when it just won’t happen. The fact that the relationship ended is the only closure you’re going to get.

4. Your time and energy are valuable and spendable just like money. You don’t go and blow all your hard earned bucks on things that are shitty and make you feel terrible, so stop blowing all your time and energy on people and things that are shitty and make you feel terrible.

5. Name as many embarrassing moments for someone else as you can in a minute. You probably cant think of much. This is how people view your embarrassing moments.

6. Treat yourself as you would treat a small child. Would you only give them fast food? Deprive them of sleep? Let them lay on the couch all day?

7. You are in control of your life. Not your parents or friends or boss or society. You may be shaped by them but you can’t live your life blaming them for everything and not doing anything to improve your situation.

8. Just because someone doesn’t buy a million dollar house, it doesn’t make the house worth less than it is.

9. It’s not moving on, it’s moving forward

10. Do not blame everything on yourself. The way you turned out to be is not 100% on you so stop feeling bad about it, stop trying to go back in time to fix it. You can however learn to manage the outcome.

11. This is your circle. Decisions you make go in this circle. You can consciously let people influence your decisions, but even that is something you did in your circle. That’s their circle. You are not responsible for what they do in their circle. You cannot live your life doing things in your circle to keep people from doing things in their circle and vise-versa

12. You can’t blame someone for how they were raised and what they experienced, but you can absolutely hold them accountable for how they treat others because of it.

13. Stop trying to understand feelings, just feel them.

14. Don’t beat yourself up for not making leaps and bounds of progress. Progress is progress no matter how small.

15. Don’t hold things in. Think of yourself as a balloon, if air is released slowly, it’s much more pleasant than if the balloon gets too full and pops.

16. Be with yourself rather than by yourself.

17. Your past may influence who you are but you do not have to be tied to it like an anchor.

18. Comparison is the thief of joy.

19. What if you just walked away? Did you forget that you can choose what you do?

20. You cannot rescue people.

21. You’re never going to be happy if your whole personality revolves around trying to be likable.

22. Be around people you want to be like.

23. Don’t live within a negative emotional moment. Negative feelings like hatred, jealousy, self doubt, anger all pass eventually. So wait for these feelings to pass before making decisions or do important tasks.

24. Your anxiety symptoms are uncomfortable, but not deadly. Try to treat them like a cold. Treat yourself, but it will also need time and patience.

25. Just because you think it doesn’t mean it’s true.

26. Good people can do bad things.

27. Don’t dwell on past mistakes. If you start overanalyzing your regrets, acknowledge the negative thoughts, and then move on to setting a goal or thinking about something you’re looking forward to instead. Try to focus on the positive, and eventually you’ll ‘retrain’ your brain to think that way more naturally.

28. As long as you’re still breathing … there’s time to change.

29. Replace bad old memories with good new memories.

30. When people want to kill themselves, they very rarely actually want to die. They want the pain to stop, and are so desperate they can’t see the difference.

31. Every family is dysfunctional, just in different ways.

32. Pick your battles. Life is too short and your peace is too precious to martyr it over arguing or worrying about the battles that don’t even matter.

33. The only thing you can change is yourself.

34. Accept your problems and try to live with it. Because life is not prefect you will always get some of problems. And be thankful for life even if you don’t feel good. Positivity is the only thing that makes us happy.

35. Life is happening for you, not to you.

36. Just because they are family doesn’t mean you have to love them and be apart of each other’s lives.

37. If crying really is your only option, it’s ok to do it.

38. Think about what’s most likely to happen instead of what’s the worst thing that could happen.

39. Try to enjoy life and not just ‘get through’ it.

40. Yes, you are going to feel like shit for a while. But you will get over it.

41. If there’s a lion behind you, keep walking. Just because it’s behind you doesn’t mean it’s attacking. Deal with the problems currently attacking you.

42. Throughout the day, when you’re not focused on doing anything, just focus on nothing for a second. Close your eyes. Take a deep breath.

43. Never take on the emotion of the situation. If you do, the situation controls you.

44. You’re not responsible for your father’s actions or behavior.

45. If you think you don’t need your meds anymore, they’re working. Keep taking them.

46. You didn’t always (specific behavior). So, you don’t always have to. You can go back.

47. Counseling is not necessarily meant to save a relationship, it’s to help you figure out what you want and what’s best for you.

48. Fuck what they think. You don’t need approval.

49. You should not rely on other people for you to feel happy. You will only burden them with your problems and put your issues on them. Same goes for them. They should not rely on you to feel happy.

50. It doesn’t sound to me like you really want to die, but that you just don’t want to suffer. That is a perfectly human reaction to not want to suffer, so let’s work on some ways to minimize that.

You Should Fire Your therapists/counsellors right now if they do these things i observed from those i work with.

After spending time in therapy of all kinds, testing with various therapists and psychiatrists, documenting my own life and conditions and staying permanently informed about therapeutic methods, I’ve put together a list of 20 most common things a therapist should never do in relation to their client. This list is not exhaustive, but it’s based on my own and my friends’ experience, clinical support studies and advice from good therapists I have met. 

1. They can’t or refuse to give you information about the type of therapy or method they use. 

This is actually the first question you should address a psychotherapist at your initial get-to-know-each-other session. They should be able to introduce themselves thoroughly from a professional point of view and explain their work method and type of the therapy they specialise in. First sessions are not just an exchange of information between the patient and the specialist, but also the negotiation of how the therapy will be assessed, how long it may last and what are the expected results based on the addressed goal. If your therapist can’t or won’t disclose such basic information, you should rather book a couple more appointments with other specialists and decide afterwards who’s best for you. First encounters in therapy are like job interviews, where you are the client and the therapist is your service provider. Make sure you know well who you want to hire!

2. They talk too much.

The focus in therapy is supposed to be on you – the client. You’ve reached your therapist’s office to seek advice, help, to understand or better yourself as an individual. A therapist should know when to open a different topic, how to guide you through a difficult emotional situation, and mostly, when to shut up. Unless they’re giving you important information about your treatment, progress or are asking more relevant insight from you, they shouldn’t be making the session about themselves.

3. They don’t keep a file or they forget important information about your case.

Naturally, therapists are humans and with the dozens of patients they see each week it’s normal to sometimes forget this or that. However, if your therapist makes a track record of forgetting crucial information about your situation, you should ask them whether they keep a file of your case. A patient file is mandatory and relevant in the sense that it contains all the important information about your past and current situation along with the progress your sessions make. If they don’t keep such journals, it’d be advisable to look for a therapist with a greater degree of organization.

4. They give unsolicited advice.

This is code red for leave, now, and it’s the one thing psychotherapists should never, ever do. Giving a patient life advice is unethical. The whole point of therapy is to become aware of your own thoughts, emotions and needs, and to be able to make decisions by yourself, no matter how difficult it is or how long it takes to reach that level of awareness. Seeing a therapist who acts like the sympathetic friend or parent who always knows what’s best for you to do is not only completely counterproductive, but can be dangerous if you’re on unsteady ground/don’t know what’s best for you.

5. They get too close to you…

…be it physically or emotionally. The relationship you develop in therapy should respect healthy boundaries. If your therapist touches you, hugs you or initiates other types of physical contact without having your consent, you are right to wonder if that’s okay, especially if you feel like they’re pushing too much into your personal space.

6. They make sexual advances to you

Run. Now. Or call the clinic they work with and tell. This is under no circumstance acceptable and your therapist should not even be allowed in his field of work.

7. They are late. Constantly.

Being sometimes late for a good reason is human, but if your therapist makes you wait for them constantly, and don’t offer extra time in the sessions, consider finding an alternative therapist who respects their clients.

8. They don’t talk at all.

Therapists don’t do much talking in general, because the focus of the sessions is on the patient. However, a mute therapist can be confusing and infuriating for most people. If they refuse to answer any of your questions, make no input and simply leave you to talk endlessly without any kind of guidance or attention, you may consider fishing for a different approach.

9. They abuse you, harass you or insult you.

I once saw a therapist who said my body lines are an ugly way of trying to make myself special, and that they remind him of the iron stamps put on cows. While I was about to burst into tears, I stood up, kept myself composed, told him he’s an embarrassment to his profession and elegantly left. If something like this ever happens to you, know that you are not there to be judged upon your body, life choices, sexuality, health or general decisions. You are there to learn about yourself and heal with the help of a professional who is not allowed to hit you when you’re at your most vulnerable. From that experience, I learned I always have a choice, and my choice was to leave and never look back.

10. They don’t respect your personal point of view.

I used to be in therapy with this lady who liked to make recommendations for my love life. When I told her I am seeing someone new and that I’m not yet sure how the relationship will evolve, she leaned back on her chair and blurted the infamous “Well, you should date more people then”. Your therapist should never question your decisions or try to influence them, unless you are hurting yourself or thinking about suicide. She couldn’t seem to relate to my desire to date monogamously out of respect for my partner, so we parted ways.

11. They constantly avoid to talk about your progress in therapy or lack thereof.

Your therapist should be able to talk openly to you about your progress. If they refuse to debate on such matters, or keep you in suspension, be sure you can end it. Knowing your own progress is crucial to functional therapy.

12. They suggest they are the best therapist for you.

No one can tell you that. Period. If you are unsatisfied with the therapy, or you want to look for a different opinion, your therapist should be able to discuss this with you and assist you in making your own decision. If they threaten you, or say you won’t find anyone like them, you are very right to leave.

13. They don’t answer/return your calls.

If you’ve agreed that you can contact your therapist on their phone between sessions, they should be able to answer or reach back as soon as possible, especially if your case presents great attention or if you’re in the danger of hurting yourself. If they simply don’t return your calls or emails repeatedly, bring up the issue in your following session. If the issue persists, you know what you have to do…

14. They say your struggles are not real or undermine your problems.

Oh, Lord. How I like these scenarios. Basically, when a therapist says something like “Your struggles are not real”, they not only fail to understand you in any way, but they essentially fail at their job. A therapist is trained in determining the gravity of your issues and in finding the best solutions for overcoming them. If they say something like that, fire them mercilessly.

15. They focus only on the cognitive/emotional side of therapy.

Therapy is a process that in its very essence helps connect the rational and the emotional. While some therapies rather focus on one of these aspects, they should never eliminate the other from the therapeutic equation.

16. They don’t protect your confidentiality.

Therapy is confidential according to law in most countries. You should be signing an agreement with your therapist/clinic when you begin working together on your case that states everything you present the therapist with will remain confidential. They’re not supposed to give away information about your case neither to family members, your employer, or other people or organizations. Should they wish to discuss or collaborate on your case with another specialist, they should have your permission.

17. They criticise your statements or decisions.

A therapist is not your parent, friend, or any other random person you meet on the street who might have something to argue about your choices or remarks. They may ask you why you consider a certain decision – but never tell you that you’re wrong, because their mission is not to influence you, but to support you into taking the right decision for yourself at a certain time.

18. They want to befriend you.

Friendship between a client and therapist is completely non advisable and a good therapist should always refrain from taking in a patient whom they know in real life. This is simply because the therapist must be able to assess your situation objectively, without any external influences that can interfere with the therapy. Steer away from being friends with them on social media or in real life, for your own good.

19. They make you feel worse.

This is widely common in therapy, but it’s more difficult to determine. Therapy means exploring bringing to surface deeply hidden or unknown emotions. This can result into you feeling more depressed, worried or anxious, as purging repressed feelings is often a painstaking process. However, you and your therapist should be able to assess the effect of therapy after the first 5-6 sessions. If you’re constantly feeling uncomfortable, inadequate or anxious about therapy, bring this up to your specialist. Unfortunately, if there’s no conciliation or satisfactory outcome, you may have to look for a different professional. Therapy is not your key to happiness and it definitely doesn’t mean you walk in there, leave your problems and then feel instantly healed – but it should make you feel more relaxed, confident and in touch with yourself after a couple sessions. If what happens there doesn’t make any sense to you, consider opting out.

20. They won’t admit whether they can help you or not.

I once had a therapist who sighed whenever I asked her if she thinks she can truly help me navigate my anxiety. This gave me the creeps in the beginning, then it made me feel much more nervous and insecure. I started to wonder what was I doing, whether she was refusing to answer on purpose or because this was a therapy technique, and why do I keep paying her. Ultimately, I gathered the courage to ask her upfront why she avoids answering. She replied she has yet to determine that. We were on our 7th session when this happened and back then I didn’t know so much about how therapy should happen or what a therapist is required to do. Now I know: they are supposed to discuss this with you in the first session, and if they determine they can’t assist you along the way, they should tell you so. Not all therapists might specialize in your situation, but you have the right to the best service and assistance, and a therapist who just keeps you in limbo to cash in more money from you or says they’re undecided is briefly playing with your time and health. Stay informed, and don’t shy away from asking anything you’d like to know. It’s your right.

Online Counseling, options that really work

Often, by the time someone mentions counseling, the marriage is already in a rough place. Few couples think to get counseling to prevent issues so when they finally admit they need help, they want help right away. Most of us turn to the internet when we are desperate and those looking for marriage counseling are no different. In the cyber world we live in, it is easy to believe that every need we have can be taken care of over the internet. Believe it or not, online marriage counseling is possible for couples who want to become closer or work on issues in their marriage.

Before you decide that online marriage counseling is the best option for you and your spouse, you need to realize that for counseling to work, you need to have the right counselor. Many people believe that anyone who is a licensed counselor can provide marriage counseling, too. However, the best marriage counselors often only do counseling for couples. Marriage counseling is quite different than any other type and requires the focus of the counseling be on the relationship, not on the individuals.

Why Choose Online Counseling

Many couples choose online marriage counseling because they are too embarrassed to go to a therapist when someone might see them and wonder why they are going. It is not easy for a person to ask for help and to have the added stress of wondering who may start rumors about their mental or emotional health may keep couples suffering instead of seeking counseling.

Online marriage counseling takes the worry away that you may be seen in the therapist’s office, even though you have no reason to be embarrassed. Asking for help to save your marriage takes courage and should be commended. Another reason many couples choose online marriage counseling is the convenience of completing the program at their pace. They may also feel it is easier to work on issues with their spouse than open up in front of a stranger, even with the guarantee that nothing that is said will be repeated.

Whatever your reason for checking into online marriage counseling, it can work for some couples. Many programs are available that offer the counseling you want so the first thing you and your spouse need to do is find the best option for you.

Online Marriage Counseling Options

When you begin your search, you may be surprised to find you have several options for marriage counseling. Before you make a final decision, you and your spouse need to discuss what type of program you want.

You can purchase sets of CDs or DVDs that will lecture you for several hours about working on marriage issues. Some sets of discs will come with a workbook that can help you understand their program while others may offer an online assessment. You may even be able to sign up for weekly (or daily) e-mails that offer marriage advice or tips to help you work through your marital issues.

These programs can be wonderful tools if you and your spouse are both willing to sit and listen (or watch) many hours of speeches. Even if the programs are well-done, this type of counseling can seem pointless if you do not like being lectured to. Many couples prefer to talk to a person and to have some give and take in the lecture. The ability to ask questions is also very important to most people. And, frankly, watching someone talk for hours could be very boring, even if that person is entertaining and knowledgeable.

Another option you have is to purchase books or download lessons to work on together. Again, these might help, but both people need to read and understand the books and agree to use the suggestions. Books are a great place to get ideas to help your marriage, but it is hard to stay with the process. An email can be ignored easily.

For those couples who want to talk to a counselor, you can even do that online. You can either use the phone or a video conference call to talk with a counselor. Many people choose this type of online marriage counseling because they maintain their privacy while still getting the help they need to save their marriage.

The costs of each type of program vary widely. Purchasing books is usually the cheapest option, but unless you are both willing to read and study the books, purchasing them could be a waste of money. CD and DVD programs can range from $50 to close to $1,000. Remember that the most expensive is not necessarily the best.

Live online counseling is usually charged by the hour. If you choose this option, make sure you ask how the hours are billed and what happens if you go over your “hour” (which is often 45-50 minutes). Do you get billed a specific amount or an entire hour?

No matter which option you choose for online marriage counseling, whether it works or not depends a lot on you and your spouse. You both need to be dedicated to saving your marriage or working out your issues before they can ruin your relationship. You may find that books or workbooks do an amazing job of helping you consider different solutions to your problems or you may need to talk to a marriage counselor. 

https://www.marriage.com/experts/

I’m a Young mother but Learning slowly by slowly what It means to be a Mother> Zam Namatovu

Zam Namatovu with Lukonge Achilees during enterview

I’m slowly learning that I will never feel alone ever again because I am the mother to twins and that will never change. As far as realizations go, this is both liberating and terrifying. Liberating in that living with unconditional love in your heart frees you from seeking love out. Terrifying in that loving someone so hard makes you vulnerable to hurt and pain. Along with every memorable moment, there’s the possibility that something might go horribly wrong at any time.

I’m slowly learning that my life has changed. I’m no longer able to do the things that were once easy, mostly for logistical reasons. I cannot meet a friend for coffee or a drink at the last minute because socializing requires quite a bit of forethought. I can’t indulge a whim to hit the town at night without planning far in advance, or paying for a babysitter. My day-to-day existence has shifted permanently to accommodate my little one. But I’m not at all resentful. I want to be with my twins pretty much always anyway. i want to forget scary memories.

I’m slowly learning that my own needs are secondary to those of the tiny creatures I’ve created. Not because I’m an especially generous or kind individual, but because that’s what being a mom entails. There’s no avoiding it, really. When your babies needs to eat, you instinctively feed them. When they need a new diaper, you don’t let them sit in their soiled nappy for longer than absolutely necessary. When they cry, you work to soothe them.

I’m slowly learning that when you’re a mom, you can no longer be so particular about things. You eat what you can, when you can. You won’t always be entirely sated, but you’ll barely register lack of satisfaction since there simply isn’t enough time. You get your nails done and your hair cut far less frequently than before, not because you’re any less vain, but because you forget to care about your own appearance. You exercise if and when you get the chance, if and when you have the energy. At some point, it becomes easier to recall how many poopy diapers you changed the day before than what you ate for lunch that very afternoon.

I’m slowly learning that being a mom is all-consuming. You never get to stop being a mom. Ever. And that’s the beauty of it. Parenthood is a cloud that hovers over you at all times—sometimes bright, fluffy, and purely innocuous, other times suspiciously dark and foreboding.

I’m slowly learning that I’m a different person now. And that that’s okay. It would be impossible to remain the same. I am my former self, plus motherhood. I am not saying that being a mom requires abandoning every aspect of your former identity, or becoming better in any way. But it does require making tough choices, and learning. It demands stripping your old self down to her core, and choosing which pieces of her are worth preserving, and which pieces you’re better off jettisoning. It requires taking a hard look at yourself through the eyes of the person who’s pretty much programmed to adore you and to mimic your every move. It requires softening your heart, and toughening your soul.

Basic counseling skills

A practical guide for students studying social work, Social work practitioners and health workers in maternal care

By Author Lukonge Achilees

Author Lukonge Achilees during counselling session at Pelletier teenage mothers foundation (PTMOF)

Many health cares faced with the emotional problems of women that they see on a daily basis. They often feel helpless because they would like to help, but are not sure about what they should do, or how they should do it.

The ability to be a good helper or counselor depends on knowing your own feelings and thinking deeply about how you behave.

I am going to help you, understand some basic counseling skills like listening, asking questions and reflecting. There is also an outline for approaches to counseling mothers during pregnancy.

INTRODUCTION

The idea of mental illness is often confusing. We have an understanding of stress, and of psychosis, but there is arrange of emotional distress in between that is often overlooked.

What is mental illness?

Mental illness affects people’s feelings, thoughts and behavior. Mental illness can have negative effects on people’s lives or the lives of their families. Symptoms of illness can include;

  • Changes in mood
  • Changes in a person’s perception of reality
  • Changes in parson’s ability to organize or focus their thoughts.

These changes can interfere with how people are to function at work, within their families or communities.

But mental illness is treatable.

People who have a mental illness may not know about it, or may be ashamed to talk about it. This makes it difficult for them for to ask for help and get treatment.

In contrast to mental illness, mental well being in when a person is able to realize their own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to their community.

Mental health is everybody’s business

Mental health care is often seen as a specialist field that only highly trained health workers can deal with eg. Psychiatrists or psychiatric nurses.

Mental illness is far more common than both health and social workers and clients often realize. Poor mental health can affect clients in many ways. That I why it is important that all levels of health workers are able to recognize mental illness.

Why don’t health workers ask about how a client is feeling?

  • Perhaps the answer will require too much time and effort.
  • It may be easier to deal with a physical problem.
  • Perhaps the question reminds health workers about their own personal issues.
  • It is often difficult for health workers to hear about client’s feelings because they may feel unable to offer help to clients

What is counseling?

Counseling involves listening. Counseling is about supporting the woman and empowering her own solutions. Counseling is not about giving advice!

What can counseling provide for woman?

  • A safe to be heard-the woman tells her whole story
  • A way to understand her own distress
  • Someone who will listen without blaming or judging
  • Respect
  • Validation of feelings
  • An opportunity to explore practical options with her
  • An opportunity to look for solutions to her problems
  • Support

What is the process of counseling?

  • Opening: establishing a relation/building trust
  • Exploring: good listening
  • Understanding: clarifying/reflecting/summarizing the problems
  • Deciding on intervention: understanding the situation that the woman is in
  • Exploring the problem to find solutions
  • Helping the woman to plan her own solutions
  • Monitoring and maximizing resilience

HELPING OTHERS

Health workers often see distressed women. It is not always easy to know how you can help or what to do.

Who can help?

Anybody can help! The exercises in this manual help you understand how best to be a helper.

You do not need to be a trained social worker or psychologist to have counseling skills can help everyone to take better care of the women that they see.

What is a helper?

These activities aim to get health workers to think about who would be able to help women in distress, and how that should be done.

Activity: who helped you?

Close your eyes, and think about a period in your life when you were very unhappy. In your mind, choose someone in whom you could confide, with whom you could share your pain. What qualities would you want from that person?

You are most likely to choose someone who would accept your feelings, not try to give you advice whom you could trust, who would not interrupt you, who would “hold” you emotionally and make you feel safe, even if they could do nothing to change your difficult circumstances.

Qualities of a helper

The following characteristics are good qualities a helper:

  • Keeping confidentiality
  • Empathy
  • Positive regard
  • Respect for others
  • Warmth
  • Being genuine
  • Being non judgmental

Confidentiality

A counseling relationship is based on trust. What is told to the helper must not be passed on to other people. Health workers need to understand how important it is to keep information confidential. Professional health workers may share confidential client information with other professionals if it is going to assist the woman’s care.

Activity: Confidentiality

Think of a secret that you have. Nobody else knows about this thing. Think about sharing this information with someone that you trust. How would you feel if they told other people? Some of the emotions that you may feel are: betrayal, anger, hurt, feeling shut down.

Keeping information confidential is giving your trust to someone-and keeping your word. As a counselor, you are in a privileged position to be trusted with other people’s important information.

Understanding others

The activity below is aimed to get health workers to think about what it might be like to be someone else.

Activity: Walking in someone else’s shoes

Think about your favorite pair of shoes. Where have those been with you? How far have you walked in them? Have they been in mud or rain? Have they been dancing?

Think about your best friend. What size are her feet? Would she be able to wear your shoes? Do you know if your feet would ft in her shoes? Do you know where her shoes have been? How has her journey shaped her shoes?

Learning points:

  • It is very difficult to know about other people’s lives.
  • Your journey shapes who you are-and it is not easy to understand something from another’s point of view.
  • There are many ways of seeing and experiencing the world and these depend on our upbringing and beliefs.
  • We need to be able to respect another person’s point of view, even if it is different from our own.
  • We need to recognize difference and similarities between people.
  • It takes a lot of thinking about yourself before you can understand something from another’s point of view.

Understanding yourself

When you are trying to help someone who is distressed, it can be very upsetting for you. It is very important that you try and think about how you feel so that you can help the other person in the best way. This is called self reflection

The following are important points on self reflection:

  • Try to give yourself time-every day-to think about how you feel and why.
  • When working-try to monitor what you feel, and ask where the feelings come from.
  • Try to notice when you feel very strong feelings about something.
  • Try to think about some of your strongest feelings, and see if they link to any of your own experiences.
  • Treat your own feelings with the same compassion and respect you would give to others.

Empathy

The terms empathy are both about feeling for somebody else’s situation, but they often get confused.

What is empathy?

  • Putting yourself in someone else’s shoes.
  • Respectfully imagining what someone else’s life is like
  • Entering into the private world of another person, without making judgments.
  • Empathy is showing that you understand the person’s experiences, behavior and feelings.

“To empathize is to see with the eyes of another, to hear with the ears of another and to feel with the heart of another”

How do you show empathy?

It is hardest to empathize with those who are different from us. In order to empathize with another, you need to be.

  • Open-minded: you must set aside, for the moment, your own beliefs, values and attitudes in order to consider those of the other person.
  • Imaginative: imagine the other person’s background, thoughts and feelings
  • Committed: want to understand another person.
  • Knowing and accepting of yourself: knowing yourself and accepting who you are helps to develop empathy for others.

Difference between empathy and sympathy?

Often we hear the words empathy and sympathy together. What is the difference between empathy and sympathy?

  • Empathy: putting yourself in another’s shoes and trying to see the world though their eyes. This does not mean that you feel exactly what they are feeling or that you have been trough everything they have been through.
  • Sympathy: feeling what another person is going through. For instance, feeling the sadness a family is feeling from loss of their child.

A helper needs to feel empathy, because you cannot possibly experience everything that people go through. You use your experiences and your attention to understand the other person’s situation.

COUNSELING SKILLS

In order to learn how to be helpful to someone in distress, there are soe useful counseling skills outlined below. The more the skills are practiced, the easier they are to use.

Listening skills

“Diagnosis helps the doctor, bt for the patient, the crucial thing is the story” Carl Jung

A good listener is not only popular everywhere, but after a while he knows”- Wilson Mizner

There is none so blind as those who will not listen” William Slater

Activity: listening

Have you ever had a helpful experience when you talked with someone about a problem? It could have been a friend or a family member who simply listened to you. They did not give you a solution, give you advice or tell you what to do. They simply listened while talked about your thoughts and feelings. Afterwards you felt better, just because you talked about it and felt heard. Sometimes, just the experience of talking to someone who listens can be healing.

Active listening

Active listening happens when you “ listen for meaning”. The listener says very little but conveys empathy, acceptance and genuineness. The listener only speaks to find out if they have heard or understood correctly.

Key points about empathetic listening

  • Listening is active
  • There is more to listening than simply not talking, or lending your ears to somebody.
  • There are verbal and not verbal components to listening. You can listen without saying anything.
  • Listening involves more than just one sense. It is not just hearing with your ears, but also involves observing with your eyes and saying things at times. It can include touch as well.
  • Active listening is also communicating what you have heard and understood.
ACTIVE LISTENING

Why should we use active or empathetic listening?

  • Empathetic listening encourages the woman to talk more about her issues. This allows you as a helper to gain a better understanding of the difficulties and her view of the world.
  • It leaves the woman with the understanding that she has been heard. Just the experience of being heard can be healing.
  • Active listening helps establish a relationship between clients and helper.

Empathetic or active listening involves:

  1. Participating in the world of the other person and being a part of what that person is experiencing.
  2. Hearing words but also listening to how the words are being said
  3. What tone of the voice is being used?
  4. What words are being used to describe the experience?
  5. What body language is the person displaying?
  6. What shows on their face?
  7. What do their hand movements shows?
  8. Do the words flow or are there lots of hesitations?
  9. Listening to what is not being said, or listening to the silences.
  10. In counseling, caring or empathetic listening is an experience where your whole being becomes tuned into the world and experience of another person.
  11. A combination of empathy and listening is a basic requirement for all counseling behavior and in itself is often very therapeutic for the client.
  12. There is healing powered in being listened to, and in being able to talk and be heard by another.

What gets in the way of active or empathetic listening?

  • Being selective: not listening to the full message of what is being said, but hearing only what you want to hear.
  • Being distracted: appearing to listen when really your mind is a million kilometers awys and you have not actually heard a word that has been said.
  • Personal values (what we believe to be important): each of us has different values
  • What is happening in your own life: this may change your perspective about what the woman is going through.
  • Preparing a response: if you are preparing what you will say next, you cannot be listening to the woman.
  • Feeling threatened by what the woman is saying.
  • Culture: sometimes the woman’s culture is different to ours
  • Language: many times we are not speaking I our own language and there can be communication difficulties with this.

Verbal listening

Minimal verbal response: these are verbal responses showing that your listening.

Verbal responses include. “mmm…..mmm,” “uh-huh,” or  “yes”

These minimal responses show the woman that you are listening to her, and encourage her to continue talking.

Non verbal listening

The SOLERF method is a useful way to listen without speaking.

S-Squarely face person- not turned to the side

O– Use Open posture without crossed arms and legs

L- Lean slightly toward the person rather than sitting back in the chair

E- Use Eye contact instead off into deep space.

R- Relax; keep it natural instead of sitting like aboard.

F- Look Friendly and welcoming rather than neutral or scowling.

Remember:

Communication is 55% body language, 38% tone and 7%words. Your client may not remember what was said, but they will remember how you made them feel.

Learning point: Active listening means that you concentrate on what is being said- not on what you need to say or do.

The following activity aims to practice active listening skills. It will also explain how to get more information from the woman by looking at what her body is saying.

Activity: Active Listening

Next time you and a friend or colleague have a chance to caht, think about listening actively. Try to listen without interrupting. Try not to say anything more than two or three words long. Keep her/him talking by saying  “uh-huh”’ really!?’, “tell me more”, etc

Think about the following:

  1. Where you able to keep the conversation going on using only encouraging body language and word or two?
  2. Where you able to keep from interrupting?

Think about what the speaker may feel:

  1. Did they feel they had permission to keep talking?
  2. Did they feel heard?

Listening: a poem

You are not listening to me when…..

You do not care about me;

You say you understand before you know me well enough;

You have an answer for my problem before I have finished telling you what my problem is;

You cut me off before I have finished speaking;

You finish my sentence for me;

You find me boring and don’t tell me;

You feel critical of my vocabulary, grammar or accent;

You’re dying to tell me something;

You tell me about your experience making mine seem unimportant;

You’re communicating to someone else in the room;

You refuse my thanks by saying you haven’t really done anything.

You are listening to me when……

You come quietly into my private world and let me be;

You really try to understand me even if I am not making much sense;

You grasp my point of view even when it’s against your own sincere convictions;

You realize that the hour I took from you have left you a bit tired and drained;

You allow me the dignity of making my own decisions even though you think they might be wrong;

You do not take my problem from me, but allow me to deal with it in my own way;

You hold back your desire to give me good advice;

You do not offer me religious solace when you sense I am not ready for it;

You give me enough room to discover for myself what really going on. Anonymous

Listening Not Listening
Be aware of your own feelings and the way that you are responding Talking about yourself or your own experiences
Try to find a private, quiet place for counseling/support Being over sympathetic Talking with other people, answering the phone
Sit still and look interested Feeling sorry for the person, and then trying to give hope or platitudes Moving around or standing up
Wait for the person to speak after you have given a short introduction Promising to do everything
Give the person an opportunity to tell her story in her own way Breaking confidentiality
Don’t interrupt the person while she is talking Interrupting the person
Show through your body language that you are listening Looking irritated or bored, yawning
Feel relaxed with appropriate silences Concentrating only on the facts and asking lots of questions.
Let the person know that you are willing to listen further Ask a few questions- ask questions only when you need more information to understand the situation. Minimizing the problem (it could be worse!) Preaching or judging Giving inappropriate advice with which the woman doesn’t agree
Make sure that the way you understand the situation is correct.     Reflect back to the person in words what they are feeling and saying. Not believing what the person is saying Feeling uncomfortable with someone else’s feelings. Over sympathetic Feeling sorry for the person and then trying to give false hope.

Asking questions

The questions we ask- open and closed-are important for counseling. They can help a person open up or close them down.

Open questions: is used in order to gather lots of information- you ask it when you want to get a long answer.

Closed question: is used to get specific information-it can normally be answered with either a single word or short phrase.

Open questions

Open ended questions have no correct answer and require an explanation.

For example:

  • What brought you in here today?
  • How do you feel about this pregnancy?
  • How does that make you feel?

Open ended questions are good for:

  • Starting the information gathering part of the session
  • Keeping the client talking

Closed ended questions

Closed ended questions are those that can easily be answered with a “yes” or “no” or brief information.

For example:

  • What is your name and date of birth?
  • Is pregnancy planned?
  • Where do you work?
  • Are you ready to stop doing that?

Closed questions are useful for;

  • For getting necessary information
  • To help the woman focus their discussion.

The following activity gets you to practice open and closed questions. Use your listening skills and remember to use your body language as well!

Activity: practicing different kinds of questions

Next time you get a chance to chat with a friend or colleague, try to practice asking questions.

Ask an open ended questions like, “How do you feel about what has happened within the past few days?”

You want them to be able to go on at some length.

After few minutes, you can try to constrain or redirect conversation by asking a close ended questions such as “Does this make you feel good or bad?” you’re looking for an either/ or answer.

Think about the different kinds of answers that are given when you ask open or closed questions.

How do you think the different kinds of questions make a speaker feel?

Important points about listening

  • It is valuable for a woman to be able to talk and be heard.
  • Talking about important things can be very hard.
  • Women need to be able to speak in a safe place, in their own words.
  • When listening, try not to interrupt.
  • Concentrate on what is being said, not what you need to say or do
  • Listen to the words said, what her body tells you, and what she not saying.

Reflection skills

Reflecting is like a mirror; it gives back to the woman what she has just communicated to us. It lets the woman what she has just communicated to us. It lets the woman know what you understand about what she has shared and communicates empathy.

When a counselor uses reflection, s/he accurately describes the client’s affective state from either verbal or nonverbal cues. By listening for and responding to the feelings of the client rather than the content of their statement you arc communicating that you can accurately sense the world as they are perceiving it. This facilitates the client’s movement toward greater self-awareness and self-understanding. In order to do this, you must listen to how the person says what they say. For example, they may speak more quickly when communicating enthusiasm (or anxiety), more slowly when discouraged, and so forth.

Example:

Client:             “So, I’m wondering if you can help me choose a new major… (pause), I suppose if I did choose, I’d just screw things up again…”

Counselor:       “You’re feeling hopeless about being able to succeed and you’re not sure anybody or anything will help.

Client:             “I just can’t figure out why things have been so difficult here. Everything came so easily to me in high school. Everyone at home still thinks I’m the smartest guy around but they have no idea that I’m really just stupid, but it’s only a matter of time.”

Counselor: “You are embarrassed that you haven’t lived up to  other  people’s  expectations of you. You feel like a fraud and that you will be discovered  at any time.”

Some behaviors you may want to try and follow are:

  1. Listen for the feelings. Remember that what the person is saying is only part of the message being communicated to you.  How the person says it is extremely important (i.e., a change in breathing or in the speed of talk, a sigh, a blush, a stammer, extra emphasis on a particular word). Any of these can be important cues to underlying feelings.
  • Frequent or idiosyncratic words which communicate emotions and feelings should also be noted. These verbal behaviors will give you clues as to the “emotional themes” of the client and their repertoire of “feeling words”.
  • Time your responses. You do not need to respond to every comment. You may simply want to smile, nod, say “Umm-hmm”, etc., until there is an occasional opportunity to reflect the feelings of the client.
  • Reflect feelings. As you listen for and find instances of a client’s expression of affect, reflect these emotions by restating what she/he is experiencing in your own words. If the client should say, “I wish I could talk to my dad about things like this, but I never seem to get up the nerve”, you might respond with something like, “You’re a little bit afraid of your dad?”

Your goal is to understand what the person is experiencing and to communicate “I am with you. . . I can accurately sense the world as you are feeling and perceiving. . .” Don’t worry about making a mistake — usually they will just correct you and go on, knowing that you are trying to understand her or him.

Importance of reflecting

  • Relationship building: reflecting is valuable in building a relationship with the woman by communicating trust, acceptance and understanding.
  • Clarification: reflecting is helpful for women to be able to clarify for themselves their problems and feelings.
  • Information: reflecting helps the counselor get information about the woman and how she views her situation.
  • Verification: reflecting helps the counselor to check her perception of what the woman communicates.

There are four different reflecting skills. These are skills that can be used at any stage in the counseling sessions, but are really important for building trust and exploring the problem.

  • Reflecting feelings
  • Restarting/reframing
  • Affirmation
  • Summarizing

Reflecting feeling

Reflecting what the client is feeling. Focus on feelings NOT the details of what is said.

Example

Woman, “I am the only one working in my family. My mother, my sister and her two children stay with me and my three kids. I can’t afford the school fees for my own children already, so I don’t know what I am going to do now I am pregnant again”

Counselor: “you sound worried and overwhelmed.”

Tips for reflecting feelings:

  • Listening for and reflect both verbal and anon verbal communication of feeling.
  • Read body language and reflect what you see if feelings are not expressed verbally.

The following activity helps to practice naming feelings.

Activity: reflecting feelings

Try to think about all the different kinds of feelings that people have. Some examples are: hate, fear, worry, stress, concern, pride, love, relief

The following examples are how women may talk about their problems. Try to name the feelings in these examples. It is useful to reflect feelings back to a client by saying something like “it sounds as if you are feeling…..” or “it seems like you are feeling……” if you’re not sure, you could ask it as a question, “So, are you feeling……..?”

  1. “I don’t know what to do about my son. He is 14 years and has not been attending school regularly. I found out from his teacher that he has been absent from classes a lot over the last couple of weeks. He also is not coming home until late in the evenings.” (worry/concern)
  • “I was looking forward to having a baby, but now it’s very different to what I was expecting. I love my baby, but I don’t like being at home all day. I miss my work and my friends there. I am used to doing what I want when I want to do it” (disappointment/confusion/loneliness)
  • “I cannot stand my boss. She is so demanding. Whenever she asks me to do something she is so rude. She just interrupts whatever I am doing and tells me that I need to do it now. Then when I do it she always finds a way to criticize how it was done.” (undermined/putdown/frustrated)
  • Things have been difficult with my husband for a while. He works far away and is only home a few times a year. When he comes home, we argue. This is not good for the children.” (Frustration/concern for children)
  • “For years and years I worried about my daughter. Now she finished  A level and just found a job last week” (Relief/pride)
  • “I just lost my job on Monday. Where I am going to find another job? Why do things never work out for me?” (Fearful/stressed)
  • “I lost my first baby. She was born too early and she did not breathe. I keep thinking about her now that I am pregnant again. She would have been 2 years old.” (Grief/loss/sad/worry for the new baby)
  • “Since I came in for my HIV test last week I have not been able to sleep waiting for my test results” (Anxious)  “I had an abortion last year. Since then I cant stop thinking about it, and wondering if I did the wrong thing. I have broken up with my boyfriend. Sometimes I think I am being punished.” (Guilt)
  • “I have been unemployed for 2 years. I do not know what to do about money. My kids and I have been staying with my sister’s family but yesterday her husband said that we have to leave because they do not have money either.” (Desperate/worried)

Restarting/rephrasing

This is saying what you understand the woman to be communicating. By doing this you are letting her know that you understand and, if you don’t are willing to be corrected.

Tips for restarting:

  • Use your own words to explain your understanding of what the woman is saying.
  • Use slightly different words that have the same meaning; do not just repeat what she said.
  • Rephrase both content and feelings.
  • Convey empathy, acceptance and genuineness
  • Be tentative and respective, i.e “I hear you saying….,” or “it sounds like….”

Example:

Woman:I am so angry with my husband. I just want to kill him; he makes me so sad.”

Counselor: “it sounds like your irritation and frustration with your husband has increased and is reaching a climax.”

Start a restating statement with phrases like:

“What I am understanding is……”

“In other words…….”

“So basically what you’re saying is………”

“Do you mean……..?”

“It sounds as if……..”

“I am not sure that I am understanding you correctly, but……”

“You sound…….”

“I gather……”

The activity below helps to practice restarting. Use your own words to show that you understand what the woman is saying to you.

Activity: practicing restarting/ rephrasing

How would you respond to the following statements by restarting or rephrasing? Use your reflecting skills.

1. Client “I start seeing this guy. We spent quite a bit of time together and I really like him. We were really careful and had protected sex. After about two months, my boyfriend said he does not want to use a condom. He said that, if ii trust him I should not ask him to use a condom. Now I am pregnant. I do not know what to do.”

Counselor: It sounds as though you were asked to make a difficult decision that you were not comfortable in making, and now you are unsure of how to deal with the consequence.

2. Client:  (crying) “last night my husband came home really late. He was drunk again. We started arguing, but it is no use. I am so angry at him. He will never change.”

Counselor: you seem to be feeling frustrated by your husband’s drinking, which often leads to arguments. You’re also unsure of how to deal with this problem, which leaves you feeling helpless, sad and hopeless

3. Client: “My mother is getting sick. She is alone in her village and only has one of my brother’s children staying with her. But, I am not sure that the boy is really taking good care of her. I am so worried because they are far from the hospital and he will not know what to do if she gets sicker.”

Counselor: it sounds like you are incredibly anxious at the moment, worrying about your mother’s health. You also seem to be concerned that the boy staying with her will be unable to look after her if necessary.

4. Client: “Lately my first born girl has been teased a lot at school. They call her names and say that she is ugly. Last night she was crying again. I get so angry at those cruel kids and want so badly to stop this.”

Counselor: it seems that you are worried about your daughter, who is being bullied at school, and that it leaves you with feelings of anger and frustration. It also sounds like you have a strong desire to protect her, but are ensure how to do this.

5. Client: “My husband passed away last month. He was sick for some time but he refused to be taken to the hospital. Now I have just found out I am HIV+. So, now I feel so confuse. I realize my husband had AIDS and he didn’t tell me, and I must have got HIV from him.”

Counselor: you sound like not only have you suffered a major loss, the death of your husband, but now you are left to deal with a life changing illness. Also you are left feeling a sense of betrayal that your husband did not tell you that he had AIDS.

Affirmation

This encourages the woman in the choices she has made. Affirmation can be for choices, knowledge or behavior.

  • This skill is very similar to how a teacher affirms or verbally rewards a learner, or how a parent might encourage a child by saying “well doe” or “you have done a good job” or “ you have done your best”
  • This may begin with the counselor affirming the client for choosing to come for counseling.
  • But, unlike the affirmation of the teacher to the learner, the key skill is something the woman can do for herself, rather than depend on the counselor for it.

For instance, instead of saying “I am so proud of you for coming back to get your test results, ” the counselor should say, “you should be very proud of yourself for returning for your results” or “…for making the choice to use a condom this weekend.”

Affirmation is an important skill for empowering clients; by affirming them, we are encouraging women in the healthy decisions and behaviors they have chosen and helping them to continue making similar choices.

Summarizing

Summarizing highlights the most important areas, feelings, or themes of what the woman has been saying.

Usefulness of summarizing:

  • Draws together the important points and make them clear.
  • Reviews the session, then briefly describes the most important points and says what could be covered next time.

Example

Counselor at the end of the counseling session

“Today you have been talking a lot about the overwhelming amount of responsibility you feel for all the family members staying with you. We have looked at ways for you to let go of things that you have no control over. We have looked at choices for responding and behaving where you didn’t see yourself as having a choice. In our next counseling session we could look at whether those new thoughts make any difference to your feelings of being overwhelmed.”

The following activity puts together all the skills you have learnt so far, and helps you to practice. It is not always easy to do it right! Learn from the mistakes that are made. The more you practice, the easier it is to use the new skills.

Activity: putting the skills together

When you next have a chance to chat to a friend or colleague, try to use active listening, reflecting feelings, restarting, summarizing and affirmation

Get ready to listen actively

Think about your encouraging body language.

Think about non verbal encouragers

Use open ended questions like “how are things going for you today?” you want the speaker to go on at some length.

Think about what the speaker is saying and reflect it.

Think about the speaker

  1. Do you think tat the speaker felt they were being heard with empathy?
  2. What did the speaker feel when they left the session?

Think about listening

  1. How did you feel inside yourself when you were listening?
  2. Did you feel you were on the same page as the speaker? If not, why not?
  3. How accurately do you think you were able to summarize the speakers information? 10%n90% why?
  4. Were you able to reflect back the person’s feelings?

Don’t worry if you are completely accurate. That is why the listener “plays it back” to the speaker using a tentative tone.

Remember, the person may forget what you said, but will never forget how you made them feel!

APPROACHES TO COUNSELING

The guidelines below offer general approaches for counseling pregnant women and mothers.

Before you start

Before meeting a mother for the first time, it is helpful to check any information that came with the referral, e.g. any screening forms, background history, letters from other health workers. It would be best to plan to see the mother 4 to 6 times, but there is always a chance you will only see her once, as she may not come back, or you may not have more time.

In the beginning

  • It is important to create a safe and supportive environment for the mothers. Reassure her that it is a good idea to get an opportunity to talk before the baby is born so that she feels more prepared when the baby comes.
  • Work out with her why she is with you today and what she expects from talking with you.
  • Listen carefully and don’t interpret or analyze. This creates safe space for her to voice the complexity of her feelings around pregnancy and childbirth. She can then even reach her own solutions, both emotionally and practically.
  • The mother will hopefully describe her life as she understands it. Tread gently. You may threaten your relationship with her if you treat her story as a collection of symptoms, habits or problems.
  • Look for examples of previous healthy coping and problem solving abilities.
  • As counselor, you may act as a bridge between crisis and coping.
  • Mothers need to know that they are worthy of sensitive and reliable care.

Containment

When feelings are painful and overwhelming, the woman may need someone to help her to hold and understand those feelings. This is called containment.

Think of a jug, when there is too much water in it, it over flows, and another container may be needed to hold the water until some of the water in the first jug has been used up. Feelings can be like this. Someone else might need to hold the painful feelings until the person is ready to deal with them.

When you work with feelings, it helps if you understand;

  • Your own fallings-where they are similar or different to others’ feelings.
  • That the feelings that you have when you work with people are valuable clues about how they may feel.
  • That getting to understand your feelings can take time. We need to have patience with ourselves and other people
  • That if your own jug is too full, you will not be able to hold someone else feelings as well.

Counseling as an intervention

If a mother is ready, you may feel certain interventions are necessary. Counseling may be used to:

  • Provide containment
  • Offer supportive suggestions
  • Offer encouragement and sensitive advice
  • Explore the problem and resolve these with new skills and support systems
  • Explore how childhood problems may be affecting pregnanacy and being a mother (this usually requires a lot of counseling skill and time)
  • Bring closure to unresolved issues
  • Provide information on emotional or physical aspects of preganancy, birth, birth and post partum
  • Provide information on infant emotions, responses and resources available
  • Provide referral to another agency, if necessary.

Practical tips

  • If the mother is in crisis or has severe prolonged symptoms, recommend a mental health professional. If she refuses, offer another appointment and follow up with phone calls.
  • If the mother is isolated and stressed but not in crisis, offer another appointment. Get the mother to explore other options such as listening to music, walking, talking to a friend etc.
  • If the woman is feeling very angry, offer another appointment and get her to write a letter to a person she is angry with, getting out all her feelings. She can decide to send it or not.
  • If the woman was abused as a child, reaffirm that it was not her fault, explore further if she will allow, otherwise simply be supportive. Try to link previous sexual abuse to trauma and labour, and the possibility that she may feel anxiety during labour. By talking about this, you can help her prepare, understand, her possible reactions and learn ways to cope with the anxiety.

Problem management

Managing problems is only possible if the counselor and the woman have lots of time together. This can’t be done in one session. In order to help the woman cope with her problems, it is important to understand how each person fits into the environment around them. This mother may be part of a family, a community and a society that could help her. On the other hand, those around her could be part of the problem.

There are several possible steps to managing problems:

  • Understanding the problem
  • Looking at options
  • Setting goals
  • Developing a plan of action
  • Monitoring and evaluation

Understanding the problem

There may be many solutions to a problem, but in order to understand what will work best for the woman, all the parts of the problem must be understood. Some issues may be hidden.

Activity: understanding problems

Try to think of a mother in your community that has problem. One problem often has many parts to it.  Try to break it down into smaller a part that’s that together make up the whole problem.

Think about the problem in the following ways:

What makes it difficult for the woman as an individual?

What helps her to cope with her problem?

What about her family makes this problem better or worse?

What about her community makes this problem better or worse?

What are different parts to her problem?

Looking at options

The counselor helps the woman to list the parts of the problem, and priotize what needs to be dealt with first. Then the counselor and the woman can discuss how the problem could be managed. The counselor and woman talk about different ways of putting solutions into action. Each option will have advantages and disadvantages.

In assessing options, it is important to positively reinforce coping behaviors that the woman shows. Resilience is a term used to describe the positive ability to cope with stress and difficulties. For example, even though it may feel difficult for a woman to get out of bed, she has come to an appointment. This positive behavior needs to be recognized.

Providing the woman with skills to cope with the problem will help her to feel stronger and more able to deal with what she needs to do-these coping skills help her to feel more in control of her situation.

Setting goals

The counselor helps the woman to decide on simple goals that may be successfully achieved. Smaller goals may lead, over time, to reaching larger goals.

Developing a plan of action

The woman needs to decide what will work best for her and the counselor helps to draw up a plan of action. The woman should feel empowered that the actions she chooses will help her to reach her goals.

Monitoring and evaluation

When the woman carries out the plan of action, both woman and counselor need to talk about how effective the action plan has been. They meet to look at how things are going, and look for solutions to any new problems that might occur. The counselor provides support as they work through the steps of problem management again. Where appropriate, the woman is affirmed for her choices of actions.

Even when you have practiced all the skills and approaches to dealing with women in distress, it is sometimes difficult to know ho to respond when.  The table below gives some guidelines

Possible responses for dealing with mothers in distress

General guidelines If she says… Don’t say…. You could say……
Don’t be judgmental I hate my husband Hatred! That’s an extreme emotion! What bothers you about him?
Don’t impose your morals. There is no God God loves you, even when you doubt him When did you start to think that?
Empathize; don’t sympathize or pity I am such a failure I feel terrible for you You are finding everything very difficult right now?
Don’t encourage blaming It all his fault He is a terrible husband Tell me how he is involved
Don’t try to solve the mothers problem. Help her find her own solution What should I do? Why don’t you ask your mother for help? What are your choices? Lets talk about them
Emphasize the positive I am so tired because my baby cries all the time You are lucky to have a healthy baby. It takes courage to say how you really feel.
Don’t be shocked. I smacked my baby really hard. You shouldn’t hit your baby, no matter how you feel. That must make you feel frightened and ashamed. How often has it happened? REFER AND BE FIRM
Don’t negate feelings. I want to kill my self Don’t be silly, you have so much to live for. Do you really think suicide is away out? Express concern. REFER AND EXPLORE
Don’t make false promises. I will never be the same again. Things will turn out fine for you in the end. That must be scary feelings.
Don’t say you know how she feels I feel terrible I know how you feel Tell me about your feelings

Caring for the counselor

One of the biggest problems for people working in the helping or caring professions is ‘burnout’. This can happen when you give too much of yourself to your work, but do not know how to take care of your needs.

If you don’t care of yourself, you can start to feel;

  • Exhausted
  • Lacking in motivation
  • Loss of job satisfaction
  • Resentment of the work that you have to do/people that you work with
  • Isolation from colleagues
  • Sick

Working with women who are traumatized can be particularly stressful.

  • Trauma disorganizes-it may make women feel muddled and interferes in their usual ways of coping.
  • Trauma interferes with relationships and trust-this may make it feel that it is hard to help women. Don’t blame yourself.
  • Trauma makes you feel exhausted and overwhelmed, if you can recognize this, then you can take steps to look after yourself.
  • Try not to take on too much. If you are overwhelmed, you will not be able to care for yourself or the woman your care
  • Look for signs of burn out-in yourself and your colleagues then you can act before it is too late.

Try to get your health facility or organization to think about taking care of the staff. The following points may be helpful to you:

  • Recognize the stressful nature of your work- what are the particular stresses that you and your colleagues have to deal with?
  • Try to take some time to think about your own needs-not just those of your clients
  • Help to develop systems of support (formal and informal) for yourself and your colleagues.
  • Speak to the leadership within the health facility or organization so that they can protect and support staff.