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Relationships and IBD
Debbie Pullen
Liaison Mental Health Nurse
Liaison Psychiatry
What is a relationship?
• Family, partners, children etc
• Social – friends, community groups, leisure etc
• Work
Other People’s Attitudes to IBD
What difficultieshave you
experiencedin your relationships
with others?
What are the challenges?
• Chronic disease with symptoms that impact on lifestyle eg pain, fatigue, toilet issues, diet etc
• Taboo subject
Challenge
• The challenge is to improve and maintain healthy relationships alongside living with IBD
Reflective Group Activities
Examples of Roles
Family / Relationship
Mother
Friend
Partner
Son
CarerWork / Task Related
Teacher
Manager
Driver
Cook Gardener
Banker
Interests / Passions
Traveller
Writer
Runner
Bookworm
Socialite
Internet lover
Lover
Personal Qualities
Listener
Learner
Organiser
Dreamer
Carer
Follower
Styles of Communication
Direct
Aggression
Indirect
Aggression Assertive
Passive
Direct Aggression
‘What you could do with…’
‘How dare you!’
‘do as I say’ ‘If I were you, I’d do it this
way’
‘I always win’‘I don’t give a
**** about you’
Traits: BossyArrogantIntolerantOpinionatedOver-bearing
Result: Get what you want but at
what price?
Indirect Aggression
‘Don’t worry about me, I will manage…SOB’
‘I’ll be ill if you behave like that’
‘I’m never angry’‘Can’t you take a
joke’
‘I’m surprised that you’ve managed that’
‘Martyrdom's my way of
life’‘You make me feel…’
Traits: Manipulative SarcasticDeceiving InsinuatingAmbiguous Guilt inducing
Result: Get your own way but people back away…
Passivity
‘I’m so sorry’
‘Nothing goes right for me’
‘You decide for me’
‘Whatever you want is OK by me’
‘I’m waiting for my life to get
better’‘I don’t matter’
Traits: Waiting MartyrdomApologetic IndecisiveMoaning Submissive
Result: No responsibility for self, therefore no guilt
feel resentful when others take responsibility
Assertiveness
‘I’m not perfect’
‘I feel…’
‘I’ll take a risk’
‘I’m OK – you’re OK’
Traits: Open DirectHonest PositiveAccepting
Spontaneous
Responsibility
Result: I like to be responsible for me and if I make mistakes,I will accept them- Balance- Not demeaning - Self respect- Control
Assertiveness
YOURFeelingsNeedsRights
Opinions
OTHERSFeelingsNeedsRights
Opinions
Communicating effectively
• Choosing important topics
• Choosing the right time
• Accepting it will take time
• Agreeing a language
• Saying no
• Repetition
• Scripting
Strategies
1) I understand…However…
Therefore…
2) Broken Record Technique
3) Scripting Tool
Broken Record Technique
Example:
Jo – ‘Jane can you take me to the supermarket in the car because it is raining?’
Jane – ‘I am unable to take you right now Jo”
Jo – ‘But it’s raining and I need to do a big shop. You know I would do the same for you.
Jane – ‘I am unable to take you right now Jo.
Jo – ‘It will only take 20 minutes’
Jane – ‘I know it wouldn’t take that long but I am unable to take you right now. You can borrow my umbrella if you like’
Jo – ‘Okay then, I’ll catch the bus’
Scripting Tool
Even
Fish
Need
Confidence
Even fish need confidence
Event
Feelings
Needs
Consequences
The ‘Toolkit’ of Assertion
• Body language• Setting the scene• Disclose feelings• Being clear• Staying with it• Empathising• Working for a compromise
Where to access help?
• If you feel you are in need of help for any aspect of your mental health you can access counselling and therapy services through your GP. Just visit them and ask to be referred
• If you feel you are not coping with IBD at all and would like help – liaison psychiatry can be accessed through your local IBD nurse
• Samaritans 08457 90 90 90
• Carers Leeds 0113 246 8338
• Relate (relationship counselling) 0300 100 1234