From person to patient, and partner to carer: the transitions and - - PowerPoint PPT Presentation
Rebecca Gray Toby Newton-John Jamie Lee Claire Ralfs From person to patient, and partner to carer: the transitions and transformations of couples affected by chronic illness and how counsellors can help them Overview Background
Rebecca Gray Toby Newton-John Jamie Lee Claire Ralfs
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video Partner
Other chronic illness resources (podcasts, books, websites)
In-session background briefing In-session guided therapeutic conversation In-session relationship checklist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video Partner
Other chronic illness resources (podcasts, books, websites) Therapist
In-session (or pre-session) briefing In-session guided therapeutic conversation In-session relationship checklist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video Partner
Therapist
In-session (or pre-session) briefing In-session guided therapeutic conversation In-session relationship checklist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video Partner
Therapist
In-session (or pre-session) briefing In-session guided therapeutic conversation In-session relationship checklist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video Partner
(adapted from ‘Gottman 19’ checklist)
Therapist
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Self-guided couples conversation Partner tip sheet Partner video Partner
Other chronic illness resources (podcasts, books, websites)
chronic illness on patient’s mood
download Patient
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Self-guided couples conversation Partner tip sheet Partner video Partner
Other chronic illness resources (podcasts, books, websites)
relationships; tips for a culture of appreciation
download Patient
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video Partner
Other chronic illness resources (podcasts, books, websites)
sufferers and research evidence
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Self-guided couples conversation Partner tip sheet Partner video
Other chronic illness resources (podcasts, books, websites)
illness is impacting on a couple relationship
Partner
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video
Other chronic illness resources (podcasts, books, websites) Self-guided couples conversation Partner tip sheet Partner video Partner
relationships; tips for a culture of appreciation
download Partner
Pre-session background briefing In-session guided therapeutic conversation In-session relationship checklist Therapist Wellbeing ‘fridge magnets’ Living with chronic illness tip sheet Living with chronic illness videos Patient Self-guided couples conversation Partner tip sheet Partner video
Other chronic illness resources (podcasts, books, websites)
sufferers and research evidence
Partner
Based on the work of Kaethe Weingarten
What comes to mind when you think of hope? The usual. ‘A butterfly, a rainbow, an undemanding bird that perches in one’s soul’ (Weingarten, 2010, p. 7) Those are common images and very ‘uplifting’, but would Chronic Illness let anyone stay uplifted like that for long? Fair point. And the higher you fly, the further you fall… That’s where Reasonable Hope comes in. It’s far more down to earth. Think sweaty track pants and worn out sneakers.
Research and Dr Google confirm ‘It’s good for relationships where couples share feelings’. But chronic Illness triggers powerful, difficult and socially undesirable feelings in couples Is the relationship strong enough to share even those
feelings? Are couples even allowed to feel these feelings? Couples hide the feelings and then feel guilty about hiding their feelings. It’s assumed knowledge that people should share feelings with their partner.
…is a a ver verb Reasonable hope is something we do, not something we have or don’t have …is a about the the f futu ture Reasonable hope reminds us that whatever else happened, the future is still up for grabs …is m modes est Because not everything can be done, reasonable hope settles for something getting done …know
dark s side de Reasonable hope accepts that despair and doubt also exist at the same time …is a about r relations
hips Reasonable hope flourishes in relationships: I hope when we hope
‘The five characteristics of reasonable hope make it a more robust concept than hope in general.’ (Weingarten, 2010, p. 7)
Is about noticing your client’s resistance to what is unjust Means finding proxy measures for bigger goals Supports modest expectations for your clients Involves remembering that uncertainty is an ally Means taking inspiration from others (Vicarious Hope)
‘The practice of reasonable hope is more a course of action that allows one to follow a path toward a goal than it is a feeling. Hoping does not preclude doubt and despair. Others can help one do reasonable hope, both in imagining the goal and pathways toward it and in taking actions towards the realization of the goal.’ (Weingarten, 2010,
Gottman, J.M. & Silver, N., (1999). The Seven Principles for Making Marriage Work; New York: Crown Publishing. Weingarten, K. (2010). Reasonable Hope: Construct, Clinical Applications, and Supports. Family Process, 49 (1), 5-25.
All relationships have problems. In fact, John Gottman says that choosing a relationship means choosing problems. You simply can’t avoid problems in relationships. Here are ten common things that people complain about in relationships and what couples typically seek counselling for (taken from the ‘Gottman 19 areas checklist’). How many of these describe the problems you face in your relationship?
1. We are becoming emotionally distant 2. We experiencing the “spill-over” of other stresses 3. We keep getting stuck on one or more issues 4. Our relationship is becoming passionless-the ‘fire’ is going out 5. There are problems in our sex life 6. When disagreements arise, unpleasant fights occur 7. Differences are emerging between us in basic values and goals or in desired lifestyle 8. Very hard events (e.g. violence, drugs, an affair) have occurred within the relationship and the relationship is not dealing with this well 9. We are not working very well as a team right now
How many did you tick? Nearly everyone ticks at least one, most tick at least a few. ALL relationships have problems, not just yours.
Source: John Gottman
Here is a list of common hopes that people have for their relationships drawn from the work of John Gottman. How easy or hard would it be for you to work towards these hopes that people have for relationships? (1=easy to do, 5=hard to do). Leave blank any item that does not represent an issue for you. I would like us to talk to each other more EASY 1 2 3 4 5 HARD I would want to receive more appreciation for what I do. EASY 1 2 3 4 5 HARD I would like it if our lives were less chaotic. EASY 1 2 3 4 5 HARD I would like our lives to be less stressful. EASY 1 2 3 4 5 HARD I would like us to have more fun than we do. EASY 1 2 3 4 5 HARD We don't have enough of a social life EASY 1 2 3 4 5 HARD I would like us to talk over a major upcoming decision. EASY 1 2 3 4 5 HARD I don't feel my partner listens to me when I am upset. EASY 1 2 3 4 5 HARD I don't feel supported in this relationship. EASY 1 2 3 4 5 HARD I don't feel that my partner is very affectionate EASY 1 2 3 4 5 HARD
Imagine tonight, after you both go to sleep, overnight a miracle happens. When you wake up the chronic illness is removed from your life, not just cured but disappeared completely from your lives and you don’t even remember having it. It’s just gone. Now imagine that you want to work on the issues in your relationship. How easy or hard would it be for you? (1=easy to do, 5=hard to do). Leave blank any item that does not represent an issue for you. I would like us to talk to each other more EASY 1 2 3 4 5 HARD I would want to receive more appreciation for what I do. EASY 1 2 3 4 5 HARD I would like it if our lives were less chaotic. EASY 1 2 3 4 5 HARD I would like our lives to be less stressful. EASY 1 2 3 4 5 HARD I would like us to have more fun than we do. EASY 1 2 3 4 5 HARD We don't have enough of a social life EASY 1 2 3 4 5 HARD I would like us to talk over a major upcoming decision. EASY 1 2 3 4 5 HARD I don't feel my partner listens to me when I am upset. EASY 1 2 3 4 5 HARD I don't feel supported in this relationship. EASY 1 2 3 4 5 HARD I don't feel that my partner is very affectionate EASY 1 2 3 4 5 HARD Even if you knew that chronic illness was affecting your ability to work on relationship issues, how is chronic illness making it easier or harder for you? That’s how Reasonable Hope can help. It doesn’t say ‘give up’, it says ‘check your expectations against your reality’.