Tag Archive for: self aware

Communication

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Did I hear you right?

Objective

  • To recognise that when you listen you might not be hearing what is being said
  • To learn to reply based on what you hear rather than your fixed agenda about what you want to say.
  • To develop a collaborative and mutual way to communicate with your partner.

‘Did I hear you right’

You will need less than 15 minutes, or 2 lots of 10 mins might be preferable. Find a quiet space without any distractions.

Part 1- Listening

  • One of you is invited to talk for 2-3 minutes. The subject can be anything but to start with I suggest something non-provocative, your day at work, time at the gym.
  • The other listens without interrupting.

Part 2- Checking how much you heard through recall

  • The other then recalls as much of what was said as possible, trying to avoid any interpretation, or additions.

Part 3- The speaker identifies omissions and interpretations

It is much more useful if this is light hearted. There will be omissions and interpretations. The aim of this exercise is to improve communication, not to judge or ridicule.

  • The talker  gives feedback. The purpose of feedback is to help the listener learn about there own listening competence.
  • Feedback to include omissions, any interpretations, any altered meaning/mistakes from the original but aim to be light hearted.

Part 4- What was that like?

  • Share the experiences of having to listen with full attention, was it hard, easy, anything surprise you?
  • As a listener were you aware of your own thoughts getting in the way of being able to pay full attention?
  • What did it feel like to be heard? Describe how you felt, any surprises, did you feel able to tell more, be more chatty?
  • What was the effect of the removal of distractions?

Swap roles-either now of another day.

You may wish to try this with harder subject matter after you have each had a turn.

‘Did I hear you right’ in action

Practising summarising to your partner what they have just said before you take your turn in a conversation.

Do you recognise that this has an influence on how you respond to your partner?

Relationships- Is Mine Normal?

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Relationships-Is mine normal?

This blog is for anyone wanting to touch base with their relationship. I aim to cover some data on relationships. To identify common problems that can occur in even the most fairy-tale union and to provide a reality check about sex in relationships. In doing this I hope to provide a little nudge to nourish and sustain your own partnership.

A little bit about me

As well as writing from a theoretical perspective I have personal experiences of the ups and downs of relationships. I am a trained couple therapist, and also have had my share of relationships long term, medium term and short term. I recognise, generally, if relationships are not nurtured or attended to, they fail. This is not through intent but because of lack of foresight, experience, time, skills, desire, fear (and occasionally self interest- as manifest in abusive relationships).

Why write a blog ?- ‘Sharing is caring’

As a species we are tribal, we like to belong to a group, we feel safe when we share characteristics of group members. This is also true for our relationships. But couples tend to only present the good side of their relationship so we don’t often experience the reassurance that our relationship is actually quite similar to everyone else’s.

Kirsten Neff, who writes on Self Compassion, describes one of the elements of compassion as ‘common humanity’. The  two others are kindness and mindfulness. When we recognise we are similar to others it can be  reassuring: ‘this is ok’. Neff calls this ‘common humanity’. Conversely, when we feel different we might want to withdraw, feeling something is wrong with us; that we are different. This can be similar in relationships.

If as a couple you feel you are not doing very well it can be reassuring to know that many of the negative experiences in relationships are had by most couples. They are caused by similar things, very often our attachment history, or  miscommunication. By writing about some of the things that are often ‘behind closed door’ I hope to reassure you that your relationship is normal, and to empower you to make positive changes.  These can both nourish you, your partner and your relationship.

Quite Interesting

2021 ONS data

  • 57.8% of adults over 16 years are living as a couple
  • Of these 75.7% in a marriage or registered civil partnership.
  • Since the last 2021 census there is a trend for more cohabitation and fewer civil arrangement

What are relationships like?

I suspect those in good relationship, feeling happy, and fulfilled are not reading this. This is what relationships can be like ‘happy and fulfilled’

Many factors impact on how likely we are to have a totally fulfilling relationship. Examples include our own ‘attachment blueprint’; how, as a child we experienced love, giving and receiving love and conditions that might be attached to love.

 

In 2021 (Meyer and Sledge) identified some of the main areas of conflict in relationships. Unsurprisingly these included-communication, personal habits, household chores, finances, parenting, decision making, quality time together, sex, screen time, role expectations, time management and finally, ‘the in-laws’.

 

Some of these we have less ability to influence than others. Individuals can take personal responsibility for strategies to manage emotions arising from things they cannot change. If your partner bites their nails, the control is with you to manage the feelings that arise. If you expect them to change ‘because they love you’ there is a big risk of failure, muddled with an irrational belief your partner doesn’t love you because they haven’t stopped biting their nails! It can be these tiny things that fester and grow and may cause a disproportionate level of annoyance towards a partner.

Very few relationships are perfect all the time. Below I have tried to enable you to see your relationship with some clarity and hope. It is likely that most of your difficulties are common amongst many couples. I first address the question of sex, how often ‘should’ we have it (it varies!)

How much sex should we be having?

  •  From International Society of Sexual Medicine

    • This society would suggest there is no normal frequency for sexual intimacy in a relationship providing everyone in the relationship is happy.

  • Research from USA

    • 50-57% heterosexuals men and women engage in weekly sexual activity (18-44 year olds over 18 year period)
    • 1.3 % no sexual activity
    • 5.2 % once or twice a year (data 2016-2018)
    • 32% 1-3 times a month
    • 57% weekly

  • 2022 Post Pandemic

    • In the UK during the pandemic  married people had a more active sex life which has continued post lockdown

  • The Good enough Sex Model

Michael Metz and Barry McCarthy 2010 described 5 recognisable purposes for sex in a relationship. These are pleasure, intimacy, reproduction, stress reduction, self esteem. Metz and McCarthy in their Good Enough Model encouraged a moving away from the aspirational ‘perfect’ sexual experience, where the fear of failure could easily result in being turned off sex, or not being able to ‘perform’.

They spoke of pleasure, for pleasures sake being a good enough reason for sex, so often the pressure of procreation or orgasm can detract from the overall pleasure of the complete experience.

    • Talk to each other!

I would also encourage talking about beliefs and attitudes around sex and intimacy. It might be through talking that you realise your ability to enjoy sex is stifled by preconceptions, different moral values, false beliefs. One of you might feel shame or guilt about certain aspects of sex, masturbation, use of ‘sex toys’ or anal sex for example, whilst the other has no inhibitions. This can create unacknowledged emotions around feeling pressurized, feeling needs not met, feeling anxious, rejection which you might blame your partner for.

As an exercise you could write down all the perceptions or beliefs you and your partner know of, or have, about one aspect of your sexual relationship that causes difficulties, and have a discussion about them. The discussion can be very helpful both in connecting to each other but also providing a neutral, non judgmental space to talk about a difficult subject.

Finally using different ways to achieve arousal can provide inspiration and flexibility. Arousal can be achieved through contact and intimacy with your partner, intimacy, self arousal through masturbation and through creative, imaginative role enactment. It does not have to end in orgasm.

Summary

Sex plays an important part in a relationship. It is also is a source of problems-insecurity, shame, different needs and expectations. Talking about sex, even to your partner may be difficult. However, the majority of these issues can be resolved by beginning a conversation and recognising your differences as well as your similarities.

Remember sex can be for-pleasure, self esteem, connection, procreation and stress relief. Enjoy.

Ways to enhance your relationship

  • Communication

Many of us believe we communicate well, we are able to express ourselves, or we purposefully put aside time to talk to our partner. Communication is 2-way. How many of us can say we listen to our partner, not to respond, not with thoughts in our head about a counter argument, but to deeply hear and attend to the meaning and emotion of what they are sharing.

To recognise that what they say is as important to them, as what you say is as important to you.

If you would like to improve your communication a short exercise to do with your partner can be found here.

  • Acknowledging Problems

There are problems in a relationship that will not go away. It can be useful to  acknowledge these and recognise that they impact on your relationship, but they do not mean the relationship is bad, failing or threatened. One of you may have an important relationship with an individual your partner does not like. Each of you are entitled to have these feelings, but it is not helpful to try and change the others mind. The problem is how to allow this person to be part of your ‘relationship’ without causing disruption.

Problems may manifest when there is a change in circumstances, for example illness or redundancy. The change can impact on the relationship and on each partner differently. Being able to talk about this without blame can be hard but very rewarding.

Some problems, when faced honestly may result in the ending of a relationship. The choice to have children or not, for example. This can be one of the most courageous things to do, ending a relationship that is working but you both want different things and therefore unsustainable in the long term.

  • Feeding the relationship

    • Spending quality time together-The ability to do this can vary depending on your circumstances. It is hard with young children, yet just as important. Many relationships fail because ‘we just grew apart when the children came along’. Having a date night is a popular concept. If you can find another couple with children offering to babysit in turns. Or choosing something you both want to watch on TV and both committing to watching it together, no popping off to do something else. Having a joint hobby, maybe something to try, even better if you want to both learn from scratch.
    • Supporting each other-relationships work best when attachment feels secure and unconditional. When making decisions it should be your partner who you seek support/encouragement from, not your friend or parent, they are secondary. Being there for your partner when they are tired, stressed, ill, angry, confused, anxious, sad; NOT needing to fix it, being alongside, understanding and compassionate. This may mean putting your own ‘stuff’ to one-side for a short period of time.
    • Collaboration-you are in this together. Having an intention that focuses on what is best for your relationship rather than what is in it for me. Collaboration and consistency supports a healthy environment for growing children.
    • Looking after your mental and physical health. Supporting and facilitating your partner to do the things they enjoy. Noticing when your partner is not able to do these and encouraging them.

  • Recognising Differences

Differences may be obvious, your sex, ethnicity, religion, less obvious include social class, politics, beliefs, even less obvious but equally significant include character traits, for example tidy, common sense, playful, hard working. Because of these differences you and your partner may have different ways of viewing the world and your experiences. Neither of you is right or wrong but it is extremely useful to explore each other’s view of the world to understand why attitudes and behaviours may appear to you to be completely weird. This level of understanding can ease frustrations and misunderstandings. Differences that might arise from your upbringing such as the importance given to ‘good manners’ or the attention given to days such as Fathers Day or Valentine’s day can be useful to explore, but more relevant is the awareness that these differences exist and may need to be negotiated.

Finally-The Negative Cycle

This is one of the most common reasons couples attend therapy. If you and your partner find yourselves acting out in similar ways after most disagreements you are likely to be caught up in ‘your negative cycle’

A simplistic description might be;

A   ‘Why didn’t you ….’

B   ‘ sorry, I forgot’

A   ‘ How could you forget..’

B   ‘ I can’t help forgetting’

A   ‘ But I told you …’

B   ‘I can’t cope when you are like this’ B takes themselves out of the room to end the argument

A    Following B ‘You can’t just leave it like this I need to know what you  expect me to do’

B   Silence.

A   Shouting/crying/stamping

This pattern of behaviour often originates in childhood, or other past intimate relationships NOT what is happening there and then. This is why it can be difficult to change without a third person to help interpret the deeper emotions that are going on in the interaction.

  • Interpretation

A- A is likely to feel let down.  They might describe feelings of not being important enough, or not valued, even unloved, irrelevant ‘invisible’. A defence of anger is the response. A is making themselves visible, important to get the attention that they feel they deserve.

B-B possible feels a failure, they have not done what was asked, emotions of inadequacy, shame, guilt may arise so they want to disappear because they possibly feel undeserving or not good enough.

A- The act of B moving away reinforces the idea for A that they are not important

B- as A continues to challenge their forgetfulness, B feels further shame. B might at this point become very defensive and shout back, or even remove themselves from the house

A- might at this point become completely confused as to B’s dramatic behaviour, after all B was in the wrong!

A and B are now feeling their relationship is on the line.

Does this feel familiar?

  • Learning from the negative cycle

The emotions that arise in a ‘negative cycle’ are from past attachment history and not from what is happening in the here and now. It takes time and self awareness to move away from habitual attachment behaviours.

A and B might have managed this differently

A   ‘Why didn’t you ….’  becomes ‘ I notice you have forgotten something and I feel as if I am not important to you’ (offering a solution ‘we can manage for the time being, its OK’)

B   ‘ sorry, I forgot’   becomes ‘ You are important to me, I hate forgetting things it makes me feel a failure, ( and also able to offer a solution- can we do anything now to remedy the situation? ‘)

NOTE- Both parties are able to acknowledge and say out loud what they are feeling. They do not react to their emotions. This also opens opportunity for the couple to show empathy and care for the other as they struggle with powerful emotions.

My Summary

When we commit to a long term relationship we do not to know what the journey will entail. It will reveal aspects of ourselves we didn’t know existed and things that might have been endearing become annoying. There will be unexpected bumps and disappointments, as well as joyful times. Manging the rough with the smooth as a team helps.

As with long term projects continue to review, modify and reflect, life and people are dynamic, we change. Be mindful of your love and intention. Be honest.

If you want further support in your relationship couple therapy is available.

 

 

 

 

 

 

 

Eating Disorders- Do you Recognise Physiological Hunger?

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Prompted by Eating Disorders Awareness Week 2015

Identifying the motivation behind our eating.

Part 1

An article on ‘Anorexia’ and ‘Bulimia’ this isn’t for me? Stop a minute. This is not about these conditions. Both Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are familiar terms to describe mental distress that has manifested as an altered eating pattern. They tend to be diagnosed when the eating habits cause physical symptoms. Unfortunately this is often years after the illness first started. The symptoms associated with AN and BN can also be attributed to other conditions delaying accurate diagnosis still more. I want to make readers aware that unhelpful eating behaviours can be disordered before they manifest in a physical illness. If you want to know more about AN and BN visit Beat Eating Disorders  or Eating Disorder Help where some really useful information and support can be found.

6.4% of adults display signs of an eating disorder. I hope this blog raises awareness of eating habits and how they become unhelpful and the lack of trust we have in ourselves.

Many parents will be vigilant towards their children, especially daughters, watching for signs of dieting, over eating, missing meals and vomiting, some may be aware of over exercising too. When does this vigilance start? It’s interesting isn’t it? The vigilance regarding what you put into your child’s mouth will start the moment they are born. It happens partly as a result of the monitoring that is done by your well intentioned health visitor, who weighs and checks your baby to see that they are ‘normal’ to check for early signs of failure to grow, really key in spotting childhood illnesses. Do you remember how keen you were to know their opinion, and these results, and how they were interpreted? How much did you pay attention to this information, getting reassurance that little ‘Sammy’ was following the right ‘centile’? Or did you have confidence in yourself that you understood your baby’s needs? I imagine with each child you had your self-confidence grew.

Perhaps it even started earlier, the great debate to breast feed or to bottle feed?

The point I am making is that from our start in life there are external influences for example; societal, health, cultural, economic and fashion that detract us from our instinct, and heighten our anxiety about what we feed our children. For some this can have an influence on our relationship with food, body image and eating habits. For others it may manifest as ‘keeping up with the Jones’. Reassurance and a sense of belonging; being ‘normal’ is very important to us. Below I demonstrate that when we are children, dependent on others, food can be attributed qualities that are not real. It is these qualities that may contribute to an impaired ability, for us as adults to eat instinctively.

Two common examples that can become deeply imbedded in our unconscious are;

  1. Food as a prize

This emotional labelling of food may start very early, the weaning infant given a ‘treat’ for eating something we as the adult perceived as not nice. Little Sammy finished the browny-green looking sludge that was a ‘casserole’, carer smiles and looks happy, and then gives Sammy something that excites (or over stimulates) his taste buds. Sammy is stimulated emotionally, seeing his carer happy and this is rewarded by sensory stimulation, in this case taste (a fix).

In isolation this is quite normal, it’s when emotional stimulation are void in other situations. Seeing a carer happy when Sammy does other things, experimenting with touch, walking, playing, etc. will provide a balance. Sammy will get a sense that many things can please the people around him.

The lesson that is unconsciously learnt is ‘If I eat my food I get something really tasty and then those that look after me are happy’

The potential unhelpful lesson is ‘If I eat all my food, I get more nice things to eat and make the people I love happy and pay attention to me’ or ‘foods that are really tasty give me an emotional fix’. Emotional fulfilment over rides physiological need. Food can be eaten even when we are not hungry.

  1. Food as a weapon

Little Sammy is still being weaned. Carer is not able to focus on little Sammy, they have so much other stuff to do. Sammy isn’t sure what is expected. He might eat some sludgy casserole, he might feel it in his hands, rub it over everything, and spit it out, all such fun. Unfortunately all busy carer sees is a mess. The carer starts to engage with Sammy, they might be cross, or just chatting, but she is at least engaged, and not ‘busy’ elsewhere. Sammy responds to this engagement and it is good. The lesson Sammy learns is ‘at meal times my carer is busy, I need to do lots of stuff to get her attention’

Unconsciously this can manifest as ‘I can use food to manipulate people to pay attention to me’

These examples describe how food can be used, unconsciously, not as a fuel to keep our body nourished, but as an emotional tool to get something we want, to feed an emotion. Clearly we all were exposed to these types of scenarios as infants, and are not all affected by unhelpful eating habits as adults. But those that find themselves yoyo dieting, eating in times of stress, or happiness or during relationship breakdowns may well be drawing on childhood experiences that had historically been useful and provided emotional satisfaction.

To help understand the concerns you might have with your own eating behaviours it is useful to take a step back and focus on becoming attuned to what is going on for you when you eat both emotionally and physically.

If you have practiced mindfulness or other relaxation techniques, you may find them helpful.

For a day or 2 each week, or more if you find it really useful, try to focus on these questions EVERY time you eat.

On these days, before you eat spend a minute or two deep breathing and focusing on something simple, such as your breath going in and out.

Ask yourself

  • Where you are on the Hunger Scale?

Hunger scale

  •   Why am I eating?
    • Because I am at an appropriate place on the hunger scale, and feel physiological symptoms of hunger
    • And/or Because it is a meal time/ a meal is to be eaten
      • If you are eating because it is a meal time, and not because you are hungry reflect on whether you can eat at a different time. Or how necessary is it for you to fit in to meal time.
    • I don’t know, I know I want this particular food.
      • If this is the case, try identifying where the need comes from. An emptiness somewhere? A desire for a sensation in your mouth which will give you pleasure (a fix) it could be anything.

Having answered these questions, eat and enjoy.

Establishing your motive for eating is useful and the first steps to changing eating habits that you know are not helpful to you.

In part 2 I will describe how this can be developed to help you become attuned to food types and self acceptance.

You may find it interesting to look into Mindful Eating, or Intuitive Eating and the organisation Health at Every Size (HAES)

Some of these ideas evolved from Judith Matz and Ellen Frankel’s book Beyond a Shadow of a Diet.

The Johari Window and Improving our Understanding of our Patients

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Joseph Luft and Harrington Ingham in 1955 created this ‘Window’ concept to understand how individuals work  within teams and to improve productivity, communication and collaborative working. It is frequently used within counselling to explore self awareness.

It is a metaphor for displaying ourselves, drawing on ideas of visibility and transparency as well as curtaining off areas to keep them protected from on lookers who may mean harm.

I wonder if this tool can also be used to understand the complexity of the patient presenting to their doctor or Health Care Professional (HCP)?

The Open Quadrant

The transparent two way picture.

This is what the patient is willing and able to show to their doctor. But what is it that the doctor believes they are being shown? And what are they willing to see? The picture is quite a simple discrete one, I believe that too often the view for the doctor and HCP is the illness and  treatment for which their patient has been diagnosed. This is not necessarily so for the patient, their presenting picture; what they make visible, may be quite different, not even on the radar of the doctor or HCP. For example they may be showing as an anxious parent unsure of their ability to provide for their children, a highly paid business man who is in denial  ‘not very ill at all’. So  despite this quadrant being ‘open’, and that our patient willing to disclose some of them self, is the same picture being seen by the doctor? Is the doctor, only looking to see a patient with an illness, not a person?

The Blind Quadrant

This area is designed to represent what the other person can see but the patient themselves cannot see. I have  interpreted this slightly differently to emphasise the knowledge the HCP or doctor has about the patient because of their illness.

This area is saturated by the doctor’s knowledge about the patient’s diagnosis, prognosis, and expected complications. So they see, or focus on their own intelligence and ‘dump’ it on the patient. Whether they are able to tune into other aspects of the patient ( not their illness) such as their bravado, courage, or fear,  would provide potential for an improved empathic relationship. Do the blind and open quadrants merge, the patient becoming the illness, detached from the person?

Perhaps the doctor too is being blind?

The Secret Quadrant

This is describing the things the patient is keeping well guarded and hidden from the HCP or doctor who will be completely unaware of them.

An acknowledgement by HCP’s that they in fact are not being presented with the whole of their patient and the patient is concealing aspects of themselves may be useful. It may be relevant to reflect: what is my patient hiding from me?Is this related to their illness?  The situation, environment? Am I being presented with the whole person? How can I facilitate openness? What impact will this have on concordance? Self management?

The Hidden Quadrant

Neither the HCP nor the patient knows what is hidden. But by providing space to explore the potential for understanding how the patient’s illness is impacting on relationships, behaviours and emotions will only serve to increase the potential for our patient to modify their behaviour  to help them reach the potential they hope for themselves. So facilitating the exploration of anxiety, poor sleep patterns, bad dreams and other negative characteristics may prove beneficial for physical health and the relationship between patient and HCP/ doctor,  and patient and their illness.

Johari-Window-Medical-Model

I would just like to conclude that there are missed opportunities within the NHS care settings that deny the patient the opportunity to be truly known by health care professionals such as doctors, who claim to wish to do patients no harm and yet understand very little about the patient they wish to avoid harming.