Is there important stuff you need to talk about together before getting married? So much focus these days seems to go on the wedding with planning for the dress, the cake, the guest list, the honeymoon … but in reality it is the rest of your lives together that you should be planning and preparing for. Premarital counselling is used to help couples prepare for marriage, as you attend a number of counselling sessions together to discuss your future life as well as develop relationship skills.
Research suggests that premarital counselling can improve your chances of making your marriage last by about 30% (source) and with divorce rates as high as they are, this is certainly something to consider. While it is more normal for couples who are religious or seeking a religious ceremony to be offered premarital counselling, every couple can be helped to pick up on the potential problems in the relationship before they become serious pitfalls. When you enter into a relationship with someone, each person brings their own values, opinions and expectations, and once you get past that initial phase of loving everything about each other, those differences will start to surface, and that is where counselling can help you to move to the next step. So what kind of topics do you typically discuss in premarital counselling? Some areas include:
Dr Jules If you are in a relationship and think any of these topics could potentially be difficult, counselling can help you to move forward. I offer a free 20-minute consultation so we can explore how I might be able to help you.
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This week I take a look at shyness. Research suggests about 90% of us say we have felt shy at some point, such as when we have to walk into a room full of people we don’t know, but many of us have figured out a defense system such as laughing or talking a lot. For some people this shyness develops into a more problematic situation and about 13% of the population could be diagnosed as having social anxiety, where our apprehension of being around others starts to inhibit areas of our life. It is a bit like imagining we each have a shyness thermostat inside us that leads us to interpret social situations with differing levels of fear, ranging from minimal to overwhelming.
Symptoms of higher levels of shyness or social anxiety include: blushing, sweating, shaking, racing heart, avoidance, apprehension of being around other people, self-consciousness, avoiding eye contact, appearing quiet and isolated at social occasions (which can also make you appear superior or you can be labelled anti-social), fear of being embarrassed or rejected, and in general being there without really being there. Over time, if the anxiety continues we become conditioned to associate others with our fearful reaction and unpleasant feelings, and because we anticipate a poor outcome we avoid what we assume will be a loss in terms of creating relationships. This distancing from people before we even give them a chance means that we lose the opportunity to seek pleasure from a sense of affiliation as well as the chance of closeness with people who could become more important to us. Imagine a teenage boy who is starting to have opportunities to interact with girls, and feeling a great deal of anxiety to the point where he freezes whenever he is around them. He then starts to avoid girls so he can feel less anxious, but over time as he compares himself to other boys this feeds into his sense of self, and his internal thoughts are that he is ineffective and unmanly. Eventually he pushes himself to go to a party and has a few drinks to try and calm himself down, but when a girl tries to talk to him he feels overwhelmed and leaves in a hurry. Word gets around his social circle that he is weird or possibly gay, which leads to him becoming even more isolated and then he starts showing signs of being depressed. It can be too easy to spiral into a self-defeating situation. It is important to remember that humans are inherently social animals; we evolved to thrive on having a relational group to exist within, and if you do therefore find yourself becoming isolated in a way that leads to you to feel unhappy then here are 10 tips to help you:
Lastly, remember that while Facebook makes it seem as though everyone except you has hundreds of friends, in reality most people have just a couple of people they can call true friends, and it is those connections that count. Focus on being more socially comfortable and eventually you will make the acquaintances that lead to real friendship. Dr Jules If you are facing a challenge in your life because of social anxiety and can’t see a way forward, then counselling can be helpful in providing support and a non-judgmental space to learn to find balance and confidence. For more in-depth help and counselling, consider contacting me in person. I also invite questions to be answered on my blog. This week, I heard from someone who is struggling with some aspects of living far away from family.
Saying Goodbye Never Gets Easier Dear Dr Jules, It is the end of the summer holiday and I feel so sad. My family have all returned to the UK after a lovely visit. I know they have their own lives and that I cannot afford to join them, but I can't stand the pain each time we part. Hi there, I feel your pain on this one. I lived in America for fifteen years and only got to see my family during the summer holidays when we would fly back to Europe. The first time we said goodbye it was unbearable and I thought it would get easier, but it never did. Eventually I gave up a good career and moved to France so I could be around family again, and yet each time I approach the train station that we used to leave from I still feel that panic rising along with the memories of all the separations. Family is so important to you and that is a gift you must not underestimate. Here are some tips I learned along the way that might help you to cope with the separation a little more easily:
Saying goodbye is never easy but it is survivable. If you ultimately decide that the pull of family is too great, then that may one day be something you all need to discuss as a family. In the meantime, enjoy the moments you have together and the memories you are making, they are something to treasure. Dr Jules If you are feeling that you are struggling to cope or gain perspective, then counselling can be helpful in providing support and a non-judgmental space to work through your problems. For more in-depth help and counselling, consider contacting Dr Jules in person This article was also posted at English Informer In France. I hope you have all had a good summer and got a break from your usual routine. To get myself back into the routine of writing I have decided to take an overview of what Counselling and Psychotherapy is, as this might help any of you who are considering seeking help. While my weekly Agony Aunt column and radio slot gives me a chance to offer some general thoughts on various topics, my real ability to help people lies in the therapy work I do with people in person.
What is Counselling & Psychotherapy? Counselling & Psychotherapy is based on talking, and the respectful and trusting relationship that builds up over time between therapist and client. Clients overcome personal difficulties and are helped to facilitate change and growth through this relationship. As a result of years of training and experience the counsellor knows how and when to ask the right questions to help the client gain insight and make effective changes.
Is there a difference between Counselling and Psychotherapy? Counselling often focuses on a specific problem while Psychotherapy might deal with more deep seated issues and encourages you to look more closely at the past and patterns that may be repeating in your life. In practice there is a great deal of overlap between the two and while you might feel you have a preference for a particular type of therapy, in reality it is often the skill of your therapist, your motivation to change, and the quality of the relationship you develop with your therapist that will be the most powerful factors in your growth. You talk about Psychotherapy, how is that different from the other ‘Psychs’? Anything to do with ‘Psych’ is to do with the mind, as in the Greek word for Psyche which means a mixture of mind, feelings and spirit. Psychotherapy and Counselling refers to talk therapy which helps a person with current personal problems or a need for deeper self-exploration. This differs from Psychology which is a science exploring how the mind works and patterns of behavior in humans and animals, or Psychiatry, which is a branch of medicine where psychiatrists must first train as medical doctors, and then go on to specialize in a study of the mind and mental health. They tend to treat patients with drug therapies and have the authority to diagnose and prescribe. Sometimes clients find a mixture of drug and talk therapies to be very beneficial, so the different disciplines are not mutually exclusive. Who goes for Counselling & Psychotherapy? We all go through phases where we feel we can’t cope, or we feel stuck. This is quite normal and when we look back on these phases we can see that they are just part of life, but at the time we can feel overwhelmed, sad, anxious or depressed. We don’t always like to burden others with our problems; friends can be great at listening but they often have their own problems. In addition, they can find it difficult to remain objective, or we might find our problems are too personal to share with them. A therapist is trained to listen attentively and objectively, their job is to offer the concentrated time and impartial perspective that friends cannot. Sometimes people also come to therapy when they are not in crisis, but because they are looking for a way to get to know themselves better, to improve their relationships and get more out of life. Countless people seek help from a counsellor or psychotherapist at some point in their lives. Men, women, children, couples, individuals, families … people from all walks of life go to therapy, and needing help certainly doesn’t mean you are self-obsessed or going mad, so don’t be embarrassed to reach out and ask. The therapist won’t ‘do’ anything to you, they can’t read your mind, and they don’t rake up the past or force you to talk about something that you would prefer they didn’t. In reality, we all know that emotional problems don’t go away if we just push through them or ignore them. Trying to do so can lead to headaches, low energy, sleep problems, stress, irritation with loved ones, depressed feelings and angry outbursts – our mental health is clearly linked to our physical health, so it makes sense to take care of both. It is worth knowing that most therapists have been through therapy themselves, in order to deepen their understanding of themselves, to resolve their own issues, and to help their appreciation of the therapy process. What kind of problems are typically dealt with in Therapy? Some counsellors specialize in specific problems such as working with addiction or sexual issues, but most will cover a wide range of general problems. If you aren’t sure, then ask prospective therapists about the concerns you are having. Often people seek one to one help with a therapist and this can allow you to concentrate on yourself and your own needs. Sometimes it is also helpful to seek Couples Therapy, where you sort out your emotional problems together, or Family Therapy, which is a highly effective way of helping everyone get along rather than letting one person (often a child who is acting out) take the blame for problems in the way the family or couple is functioning. What happens in a Counselling Session? Typically, a session lasts for one hour and takes place once a week or regularly over a period of weeks or months, depending on the arrangement that works best for the client and therapist. Usually there is a goal that you form with the counsellor, or something you are working towards together, and your counsellor helps you to stay on track in working towards that. You spend the hour talking together, and sometimes your therapist will suggest things they would like you to do in-between sessions, kind of like homework, to keep the momentum going. Most people initially go for short term help to tackle a specific issue and to see if therapy works for them. As things develop you might find you want to extend the therapy, or you might want to take a break and go back for more help later. Therapy might be offered for free through your health service or through your school or employer. Otherwise, you might want to seek a private therapist. Fees vary widely and should be openly advertised by the counsellor; there may also be some concession available if you have a low income, so it is worth asking. Counsellors often offer a free or low cost initial meeting where you can decide if you want to work together. When you first meet the counsellor, take the opportunity to ask questions and decide if this is the person you want to work with. Ask yourself if you feel comfortable being open with this person? The more open you can be, the more you will get out of the therapy process. Don’t be afraid to ask them about their training, their experience, their supervision and anything else about their counselling qualifications that seems important. Where can I find a good counsellor or psychotherapist? If you are in the U.K., start with your GP to see what is available on the NHS, or see if there is a service available through your school or workplace. You can also try looking on the British Association for Counselling & Psychotherapy website at http://www.itsgoodtotalk.org.uk/therapists/. If you are outside the U.K. and in Europe you can also try your local health service, or look at this site for France and Spain, and know that many therapists in Europe now offer services via Skype so that distance doesn’t have to be a problem: http://counsellinginfrance.com/ It is also worth asking around your friends and local community for recommendations to a good therapist. You might be surprised to find out how many people you know have already seen a therapist! I am of course available to consult if you are considering entering into therapy, and I wish you the best of luck on your journey! Dr Jules (Julie Askew, PhD). When we first get together with our partner or spouse, we believe that love will conquer all. In most marriages and committed relationships however, there are areas of difference on which there will never be total agreement, and these can threaten to tear the relationship apart.
The life of an ex-pat (I dislike the phrase, so if you do too please just insert whichever word you prefer) is inherently filled with emotions that conflict: sometimes we are smitten with the new country and its culture, its ability to fulfill our passion for adventure, and other times we long for the familiarity of home with family, friends and a language we can slot into without effort. When these opposing emotions are equally divided in a couple so that one spouse is the adventurer and the other longs to return to the home country, it will inevitably be a source of conflict. I see this often with British couples in France where it is the wife who is missing children and loved ones back home and finds her role in France less defined, while her husband has a work life and the social contact that goes with it. If there is a house renovation project involved this can heighten the conflict as the compromised living situation and dwindling savings add to the stress in the relationship. So how do you solve the problem? The easy answer is to throw in the towel and divorce; “irreconcilable differences” is after all one of the commonly cited reasons to end a marriage. The tougher solution is to put the relationship first and come up with a compromise that keeps you together. Marriages are fraught with many challenges, and it is how we face these challenges that can make us stronger as a couple. Some tips to help you are:
When you are torn between two countries as a couple, ultimately there is not a one-size fits all solution. I have seen many compromises such as moving back to the UK together, one spouse going back to the UK more often, finding a way to feel happier and more invested in the new country, or even moving to yet another country that you both agree on as a new adventure. Know that this is an area of conflict you can solve together if you are willing to put the work in, and ultimately it is about compromise and learning to bend rather than break. As marriage researcher Dr John Gottman reminds us: “Compromise never feels perfect. Everyone gains something and everyone loses something… the important thing is feeling understood, respected, and honored in your dreams.” (https://www.gottman.com/blog/exercise-the-art-of-compromise/). Dr Jules If you are facing a challenge in your relationship and can’t see a way forward, then counselling can be helpful in providing support and a non-judgmental space to learn to work together. For more in-depth help and counselling, consider contacting Dr Jules in person - Julie Askew PhD This article was featured on English Informer in France ‘Self Confidence: the ability to trust or feel secure in yourself and your abilities’
Hands up, how many of you would describe yourself as confident? Whether it be giving a speech to an audience, asking someone out on a date, or just going into a shop in another country when you don’t speak the language very well, how do you get by? If any of these scenarios would make you feel anxious then don’t worry, confidence is not something that is elusive or that only a few are blessed with, it is a quality that can be learned. And confidence is best when you build it for yourself, rather than hoping another person will give it to you. In counselling I find that many of my clients are struggling to feel confident in certain areas, so here is a basic tip you can try yourself at home:
I used this technique myself when I had an important oral examination to sit in front of a panel of doctors, and I can promise you that it works. The feedback I got from my examiners was one word: “impressive”. If you start rehearsing your confident behavior in your mind, your brain and body will soon start to believe it. So go ahead and impress yourself with your new confident identity! If you are feeling stuck with your life and can’t see a way forward, then counselling can be helpful in providing support and a non-judgmental space to explore your options. For more in-depth help through counselling, consider contacting Dr Jules in person via the contact page on this website - Julie Askew PhD - Dear Dr Jules
My husband has had to go into hospital and is likely to be there a while, and even when he comes home things will be different for some time. I am finding it hard to cope without him, plus the travelling to the hospital regularly is hard and I’m feeling lonely without him around. I can’t afford paid help around the place while he is out of action. Any ideas? Hi there, I’m sorry to hear about your husband’s health problems, and wish him a speedy recovery. Although we promise to care for each other in sickness and in health when we marry, we don’t necessarily think it will ever happen to us, nor do we discuss how we will cope if it does. In reality, many couples have to face health issues in one or both partners, particularly as they age. My own parents, for example, have spent the last few years with first my father, and now my mother, being out of action for prolonged periods, with the result that one or other of them has had to carry the load for both. Coping with a spouse who becomes ill always requires a readjustment in a marriage, particularly if that illness is likely to be chronic. Here are some ideas that might help you in your current situation: 1. Coping with Changing Roles When you got together you had assumptions about the roles a husband and wife take on, and these tend to evolve over time. For example, who does the cooking, the gardening, or manages the finances? When one of you is out of action for a while, these roles have to shift and you might be faced with learning new skills which can be demanding and leave you feeling helpless at times. Don’t feel like you have to carry everything yourself. If the house isn’t cleaned for a while, or you have to eat beans on toast every night, know that the world won’t end. Do what you can do and don’t worry about the rest, especially if you are busy running back and forth to the hospital. 2. Feelings about your partner may change If you have to take on more of a carer role for a while, it is natural to feel differently towards your partner from time to time, especially if he is no longer as strong or independent as he once was. Complex feelings like anger and guilt are normal, and part of the adjustment to a change in the balance in your relationship. 3. Remember to take care of yourself too It is easy to get dragged into a routine of caring for the other person while forgetting about your own needs. Remember to take some time out now and then to think about what you need and don’t feel guilty if you take a break. It is an important part of your survival. 4. Understand your partner’s emotional reactions Your husband will be experiencing a range of emotions at being unwell and at times he will feel helpless. Sometimes he may even seem angry at you or say things you find hurtful. Don’t take it personally, and don’t feel responsible for his emotions. Let him work his way through the process of adjustment and be there for him when he is ready to talk about it. 5. Do ask for help and support Now is the time to let friends and family know that you need them. Maybe someone can bring some food round to save you having to cook, or perhaps someone can help with the garden or run you to the hospital when you are tired? You might also just need a cuppa and a chat with a girlfriend to feel better. It is at times like these that you find out who your true friends are, so don’t be afraid to push a little. If you need ongoing help, you can also ask the hospital social worker to see what is available in the community, as well as checking out online sites such as HelpX where you can find volunteers to stay with you short-term to work on manual tasks in exchange for food and accommodation. The impact of an illness on a marriage can be significant. Some couples find that it ultimately makes their relationship stronger, while others buckle under the stress. Understand that the illness will have an impact on you both, and then work together to figure out a way to survive it. You have faced challenges together before, and you are strong enough to get through this one. Dr Jules If you are feeling overwhelmed or stuck with your life and can’t see a way forward, then counselling can be helpful in providing support and a non-judgmental space to explore your options. For more in-depth help and counselling, consider contacting Dr Jules in person. You can follow my posts on English Informer in France as well as on Ex-Pat Radio
Losing your best friend: Coping with the death of a pet I recently had an inquiry from someone wanting to know about coping with the death of a pet. This seemed particularly pertinent as just this week I have had make the decision that every pet owner dreads, and have scheduled my elderly dog for his last trip to the vet. Many people share an intense emotional bond with the animals in their lives, they are part of our daily routine for many years and often we derive comfort from them when we feel the need for support and affection. My own dog, for example, was the one reason I hung in there and kept going during a period when I felt particularly alone and lacking in control of my life. The grief we feel when our animal companions die can be intense, and can vary according to factors such as the role the animal played in our life, its age and the circumstances of its death. If you live alone and your pet is your only companion, or if it was an assistance animal such as a guide dog, then you may feel the loss to be overwhelming. As with any death there is no right way to grieve, it is a very individual process. Whether you feel the need to cry intensely for a few days, or you feel your grief continues to return in waves over months or even years, allow yourself the space to be immersed in the feelings and then breathe your way back again. With the passing of a human we have rituals to mark the transition, such as a funeral or a wake, and these occasions are important in helping us to grieve and move on. You might find it would be helpful to have some way of marking the passing of your companion animal, such as a burial in the garden or a gathering of folks who knew your pet. Children, especially, will benefit from inclusion in the process and an understanding that sadness is a normal part of life. Pets are often their first introduction to the process of life and death, and an important way of learning to understand the emotions that accompany this event. Sometimes people devalue the loss of an animal as they feel it is not in any way similar to the loss of a person. Don’t be distressed about whether your grief is appropriate or not, just find people who understand how you are feeling and who will be there to support you. After the death of your pet, be kind to yourself and remember the good times you shared and the love they brought to you. Maybe it would be helpful to create some kind of memorial such as a scrapbook or a tree planted in their name? Grief is a natural, if painful part of life. The feelings will decrease in intensity over the years, and slowly you will adjust your routine and move on, possibly to even considering sharing your home with another animal in the future. If you feel, however, that your emotions are leading you to become depressed and less interested in life, or if you have had other major losses at the same time such as a child leaving home, the loss of a job, or other bereavements, then do consider seeking professional help. Dr Jules If you are feeling stuck with your life and can’t see a way forward, then counselling can be helpful in providing support and a non-judgmental space to explore your options. For more in-depth help and counselling, consider contacting Dr Jules in person. This article is dedicated to memory of my dog Louis who passed away peacefully on 6th July, 2016. I wish you an eternity spent chasing squirrels little guy, and I will be forever grateful for your companionship. Since the recent referendum results in the UK, I have been observing a lot of emotions flying around on social media. Many people are shocked, anxious and wondering how to live with the uncertainty that will likely linger for some time.
So, without wishing to get drawn into the political discussions here, I wanted to deviate a little and look at the effect these kinds of emotions can have on us. On a chemical level, ongoing anxiety releases cortisol into our system. Cortisol is a hormone produced in the adrenal cortex of your kidneys, and in normal healthy life its levels change with the time of day, being highest when we wake up in the morning, as the cortisol helps us to feel alert and ready to go. It also helps the body to deal with stress or imminent threat by shutting down less necessary functions such as the immune system (hence we tend to be more susceptible to infection when we are stressed and anxious) so that we can save our energy to flee dangers such as sabre toothed tigers. Well obviously most of us don’t get chased down by hungry animals anymore, but we lead life styles where the short lived stress response has developed into a chronic one, and thus our systems are flooded with cortisol on an ongoing basis. When your cortisol is in balance with your serotonin and dopamine levels you are able to regulate your sleep, appetite (for food and sex), and your energy levels, but when you are stressed and worried for a more extended period the over-production of cortisol and resulting stress on the adrenals can lead to signs you may recognize, such as poor sleep, waking feeling tired, craving unhealthy foods, putting on weight, low blood sugar, brain fog and eventually symptoms of depression. The French have a phrase ‘Débrouiller’ which means to unravel or unscramble. So if you have spent the last few days feeling like you need to unscramble your brain and emotions, then here are some tips to help:
During a particularly stressful period in my life, a wise friend once said to me “it’s just a piece of time”. This might be a worrying time for you at the moment, but eventually it will pass and one way or another you will survive it. Dr Jules If you are feeling unusually stressed and anxious, then counselling can be helpful in providing support and a non-judgmental space to help you move forward. For more in-depth help and counselling, consider contacting Dr Jules in person Some women sail through menopause, while others finds it takes over their lives. Either way, we all face it eventually, so this week I have decided to give a quick overview of menopause with some thoughts about how to survive it. It is a big change in any woman's life, so don't feel you have to downplay it or allow loved ones to make you feel it isn't worthy of a little extra TLC from time to time. You can also read the article at English Informer in France or listen to me talking about it on Ex-Pat Radio tomorrow morning.
Coping with Menopause Menopause is a normal event that every woman goes through which marks the end of her reproductive phase. It is caused by a change in the hormone balance, which is triggered by the ovaries as they move towards cessation in the release of eggs. Menopause usually occurs as part of the aging process, typically occurring after the age of 40, although the average age can vary by race and country. In India for example, the average age of menopause is around 44, whereas in countries in the West such as England the average age of the last period is 51. If a woman starts her menopause before the average age range for her community it is said to be a premature menopause, and of course a woman who has her ovaries removed for any reason, such as hysterectomy, will find herself plunged into sudden and dramatic surgical menopause, without the long lead in that most women experience over the perimenopause period of several years. So why am I talking about menopause today? Well it is something that affects every woman and generally we women just put up with the symptoms regardless of how challenging they are. These symptoms can include fatigue, irregularity in the menstrual cycle, sore joints, sudden hot sweats that can be so severe a woman has to get up and change her sheets in the night, insomnia, urinary problems, headaches, painful breasts, back pain, poor concentration, memory problems, changes in sexual function and desire, and mood swings. While symptoms vary from woman to woman, if any woman is unlucky enough to experience multiple and severe side effects then you might imagine she could feel overwhelmed at times. From a therapy perspective, there are several areas around menopause that are less often discussed, but that are nevertheless important to consider. These include: * Body image. For women who enter menopause at midlife, there is often an accompanying change in weight, skin and hair condition and a general sense for many women that their body is changing. This can have a negative effect on a woman’s self-esteem as she sees evidence that her body is aging. * Life stage changes. Women in their 40s and 50s are often juggling multiple roles such as work, caring for older children and caring for parents, thus making everything feel more challenging than usual when perimenopause starts. Midlife women are also facing the psychological reality of their own mortality as they transition from fertility to bridging the gap to older age. * Partner reactions. The reaction of the woman’s partner at this time is very important, as is the reaction of those close to her like her kids. If everyone just thinks mum is going crazy or passes it off as ‘that time of life’ then she may feel she is struggling alone. Partners need to help by asking what the woman is going through and showing support and understanding. So if you are a woman who is going through menopause, then know that you are not alone, and you do have a right to ask those around you to show some TLC when you need it. Take time to think about what this life change means to you. Even if you didn’t want more or any kids, how do you feel now that the choice is being taken away from you? You might have spent your adult life wishing you didn’t have to suffer through your menstrual cycle each month, but what is it like not to have a period anymore? It is okay to grieve and shed a tear if you need to, and it is also a good idea to have some kind of ritual to mark this transition in your life. And then when you feel you are through the worst, remember that you are still a valuable and awesome woman with loads to offer, so get out there and show the world what a baddass you are! Dr Jules If you are finding life challenging or feel your relationship could use some help, then counselling can be helpful in providing support and a non-judgmental space to explore your options. For more in-depth help and counselling, consider contacting Dr Jules in person |
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