Kashmiri women's perceptions of their emotional and psychological needs,and access to counselling

This paper explores the meaning of mental illness for Kashmiri women, the issues that cause them distress, their coping mechanisms, and their perceptions and understanding of counselling. Interviews were used to compare the experiences and attitudes of two groups of Kashmiri women: those born in Britain and those who had been brought up in Kashmir and had settled in Britain as adults. It was found that Kashmiri women in this study had a clear understanding of mental illness, with little difference in beliefs between those born and raised in the UK and those brought up in Kashmir. In both groups the majority of those who were not aware of formal counselling still wanted to talk to a professional about their emotional distress. The majority of UK born women, and a smaller proportion of Kashmiri born women, were aware of counselling. Most women associated it with talking to someone about one's feelings, about problems in one's heart, in one's mind, and as a means of support when experiencing distress. The implications of these findings for practice are discussed.     

Men's experience of considering counselling: ‘Entering the unknown’

Agency statistics in the UK and North America reveal that fewer men than women attend counselling, at a ratio of about 1:2. This study investigated men's experience of considering counselling, with the aim of gaining further understanding of factors that might contribute to the existing gender discrepancy in utilisation of counselling. Following responses by 47 men to written questionnaires, 10 men who had considered and ultimately attended counselling were interviewed, and a grounded theory method of analysis was used to generate and analyse the participants' experiences. Three interconnected categories emerged: societal perceptions of counselling and gender roles; change of experience over time; and knowledge — ‘knowing’ and ‘not knowing’ the protocols of counselling. The implications of these findings are discussed. It is recommended that prospective male clients should be provided with information about the counselling process, and that there needs to be increased awareness by counsellors and referring agents of male gender issues.     

Anger and denial as predictors of cardiovascular reactivity in women

The relationship between behavioral and physiological reactivity and cardiovascular disease has been extensively researched in men, indicating that the expression of anger may be a contributory factor in the development of coronary heart disease. Few studies, however, have focused on women. Among these, women generally have been found to be less reactive to laboratory tasks than men. In the present study, 45 women aged 19–21 years were selected to represent three groups—(1) low anger/low denial, (2) high anger/low denial, and (3) low anger/high denial—based on their scores on the State-Trait Anger Expression Inventory and the Marlowe-Crowne Social Desirability Scale. Subjects received three conditions: (1) no feedback, (2) error feedback without observer present, and (3) error feedback with observer present. As hypothesized, women who reported a high level of denial and low anger exhibited elevated stress-related reactivity. The results are suggestive of a subgroup of highly reactive women not previously identified within the literature. The hypothesis that all groups would display greater reactivity in a condition providing error feedback with observation was not supported.This study was supported by a research grant to Carol S. Emerson from the Women's Research Institute of Virginia.     

Rejection hurts: The effect of being dumped on subsequent mating efforts

Many of the qualities that people seek in a long-term partner are not directly observable. As a consequence, information gathered through social learning may be important in partner assessment. Here, we tested the hypothesis that finding out potential partners were rejected by their last partner would negatively affect participants' desire to pursue a romantic relationship with them. Results support this hypothesis, and this effect was, as predicted, greater when the target was being evaluated for a potential long-term relationship compared to a sexual relationship. In a more exploratory vein, we tested the effect of the target having rejected their last partner and failing to disclose how their last relationship ended. These scenarios produced intriguing sex differences, such that men's ratings of women fell after learning she had rejected her last partner, but women's ratings of men increased after the same information was introduced. Failing to disclose information about a past relationship was unappealing to both men and women, though particularly so for women.     

Experiences of Pre-Implantation Genetic Diagnosis (PGD) in Sweden: a Three-Year Follow-Up of Men and Women

Men and women with a hereditary genetic disease are faced with different options when they wish to become parents. One is pre-implantation genetic diagnosis (PGD) which is a combination of in vitro fertilization (IVF) and genetic analysis of the embryo before implantation. The present study focused on men and women’s psychological experiences of PGD three years after applying for PGD. Nineteen women and seventeen men (i.e. seventeen couples and two women) participated. The interviews were analysed by thematic method. It is better to have tried was identified as a master theme, under which came three underlying sub-themes, which had the following headings: Practical experience of PGD, Psychological experience of PGD and Goals of PGD. The results show that men and women three years after PGD are still psychologically affected by their experience. The men and women raised concerns that their relationship had been affected, both positively and negatively, and feelings of anxiety and depression still remained. Healthcare services should recognize the heterogeneous nature of the group being studied and therefore the need for counselling can arise at different times and in relation to different areas, regardless of the outcome of the PGD.     

Clients talk about their experience of seeking counselling

The purpose of this study was to explore the help-seeking behaviour of a sample of counselling clients using a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in, affordable counselling agency located in a mid-sized city in New Zealand. Specifically, clients were asked if they had received counselling previously, what efforts they had made to solve their problems before seeking counselling and with what success, why they chose this particular agency, their initial impression of their relationship with their counsellor, and their reactions to participating in the research. The data were analysed to ascertain themes associated with their decision-making and choices. Findings were discussed in relation to the literature on seeking counselling, how clients determine their need for counselling and the process they go through in deciding when and where to get it. Implications for counsellors are discussed.     

Marital systems of agoraphobic women: contributions of husbands' denial and projection

The problems of measuring psychological concepts such as repression and denial are discussed in the context of the marital systems of agoraphobic women and the credibility of a couples approach to treatment. Repression, denial and projection in husbands were inferred from systematic measurement of mood, hostility and symptom changes after intensive behaviour therapy for the agoraphobia. The results suggested that the agoraphobic symptoms of about half of the women were reinforced by their husbands' habitual denial of affect and of personal problems; in this group, worthwhile symptomatic improvement occurred only in those women whose husbands relinquished repression and denial as major defence mechanisms, acknowledging their own personal problems, and allowing the patients to take more responsibility for their agoraphobia. The marital systems of the remaining couples were characterized by incompatible ways of dealing with hostility, with husbands' abnormal extrapunitiveness reinforcing patients' self-blame, which inhibited problem-solving and hence indirectly perpetuated the agoraphobia.     

Denial of the Parental Alienation Syndrome Also Harms Women

Denying reality is obviously a maladaptive way of dealing with a situation. In fact, denial is generally considered to be one of the defense mechanisms, mechanisms that are inappropriate maladaptive, and pathological. In the field of medicine to deny the existence of a disease seriously compromises the physician's ability to help patients. If a physician does not believe that a particular disease exists, then it will not be given consideration when making a differential diagnosis, and the patient may then go untreated. This is in line with the ancient medical principle that proper diagnosis must precede proper treatment. Or, if for some external reason the physician recognizes the disorder, but feels obligated to use another name, other problems arise, for example, impaired communication with others regarding exactly what is going on with the patient, and hence improper treatment. This is what is occurring at this point with the parental alienation syndrome, a disorder whose existence has compelling verification. In this article I discuss the reasons for denial of the PAS and the ways in which such denial harms families. Particular emphasis will be given to the ways in which this denial harms women, although I will certainly comment on the ways in which the denial harms their husbands and children. In the past, denial of the PAS has caused men much grief. Such denial is now causing women similar grief.     

Psychosocial factors influencing American men and women in their decision for sterilization

A self-administered questionnaire was answered by nearly 300 surgically sterilized men and over 200 such women 6 weeks after their surgery. Nearly half of these Americans were from large families. More women than men reported a history of medical, gynecologic, or psychiatric problems; one half had been pregnant four or more times; one third reported recent pregnancy. Most sterilized people reported an unsatisfactory contraceptive history. Despite that women had more complications from the procedure than men, improved psychosocial adjustment between 6 weeks before and 6 weeks after sterilization was reported by more women than men.     

Juggling roles and expectations: dilemmas faced by women talking to relatives about cancer and genetic testing

Health professionals do not inform their patients’ kin about BRCA1/2 test results or genetic testing without their written consent. Thus, the onus is on women attending genetic counselling to talk to relatives about the family history and their potential increased risk. This communication process within the family is largely unexplored and provides the focus of the present study. Fifteen healthy women attending a genetics clinic for predictive testing were interviewed prior to receiving their test result and again 6 months later. A grounded theory approach was used. Findings illustrate the dilemmas women faced in juggling social roles and expectations, which had an impact on communication within the family in the context of predictive genetic testing. Tensions between responsibilities towards themselves and others and their fulfilment of social roles had an impact on who women informed and on how they did so. These factors should be considered when assigning patients the role of information provider.     

Sex as an obligation and interpersonal communication among Norwegian heterosexual couples

This study examines the prevalence of having sex as a means of satisfying one's partner among a random sample of 398 heterosexual couples with non-problematic, mild or manifest reduced sexual desire. Data collection was carried out by questionnaires. Two of three women and one of five men with manifest distressing reduced sexual desire had had obligatory sex. Among women with symptoms of mild reduced sexual desire, there was an association between obligatory sex and lack of acknowledgement of one's sexual needs, as well as a lack of communication with one's partner regarding how to be sexually pleased. In men with manifest reduced sexual desire there was an association between obligatory sex and discussion of one's sexual needs, and sexual fantasies with the partner. Thus, men with desire problems seem to communicate with their partner about their sexuality, whereas women seem not to talk with their partner about their sexual needs.     

Don't leave me: the effect of dependency and emotions in relationship conflict

Two studies examined how the effect of dependency and emotions on the dynamics of relationship conflict differs between men and women. In Study 1, 96 women and 67 men were presented with conflict situations that might occur in their relationship; the probability of aggression, anger, and dependency was measured. Results showed that anger mediated the relationship between dependency and the intention to use aggression, in men, but not in women. In Study 2, 95 women and 65 men wrote about a conflict situation that they had experienced with their partner; loyalty, guilt, and dependency were measured. Results showed that dependency predicted loyalty among women, and that this effect was mediated by guilt.     

Gay men's experiences of therapy

Fourteen gay men were interviewed using a structured interview schedule to explore their experiences of being in therapy. Particular importance was given to their perceptions of how their sexual orientation impinged on the counselling process and how their assumptions about counsellor sexual orientation affected the therapeutic relationship. The limitations of using structured interviews in qualitative research are acknowledged. Some significant findings were made, which were not well documented in the literature, such as the impact on the therapeutic relationship of internalised homophobia within gay men themselves. These findings hold the potential to inform counselling practice with gay male clients. Recommendations are made in relation to both practice and further research.     

Depression und Paarbeziehung

The close relationship between depressive disorders and couple relationships has been well proved empirically.Conflicts and problems within the couples'relationship can be a significant trigger for depression. In additition, the quality of the relationship is often markedly impaired by depressive disorders, in many cases far beyond the depressive phase.The couples'relationship also influences significantly the course of depressions, especially when the disorders are not yet chronic.The link between depression and couples'relationship seems to be stronger and more evident for women than for men. Furthermore there seem to be patterns of interaction in couples with a depressed partner, which differ from those in healthy or other clinical comparison groups or distressed couples without depression.These patterns need further exploration with regard to different subgroups of depressed patients and phases of depression.Couples' therapy has been proved to be effective in the treatment of depression on the symptomatic and on the relationship level.Conjoint assessment and counselling sessions with depressed patients and their partners should be conducted regularly.For patients suffering from an ‘anaclitic’,‘sociotropc’form of depression couples' therapy in a more narrow sense is usually indicated. In the treatment of depressives of the ‘autonomous’ ‘introjective’ type partners should be included into treatment for the assessment and the working through of specific conflicts concerning the relationship.     

What women think and what men think women think: perceptions of abuse and kindness in dating relationships

The purpose of this study was to investigate how college women and their boyfriends viewed their relationships in terms of both abuse and kindness. The women filled out the Psychology Abuse-Kindness Relationship Inventory for themselves and their boyfriends responded to the questionnaire as they thought their girlfriends would. Several intriguing findings resulted: (1) Men thought their girlfriends would respond more negatively about the relationship than the women actually did. (2) Certain aspects of the relationship resulted in more discrepancies between the men's and women's perceptions. (3) Women distinguished present from past relationships by describing the former as more positive and the latter as more negative; men made no such distinction. Alternative explanations were offered to account for these results including projection, denial, projective identification, lack of psychological separation within couples, men's emotional upbringing and deeply rooted feelings towards women.     

Psychological trauma associated with AIDS and HIV infection in women

The growing numbers of women faced with HIV infection and AIDS has specific counselling implications. This paper analyses the psychological needs of all women patients seen by the psychology department (n = 33) over the past 12 months. The mean age was 32.3 years. Psychological crisis was high. Four women reported rapes (three accounting for their HIV infection). Two women had suicide attempts (one on two occasions), Death experiences were notable, including multiple bereavement. Conjidentiality was problematic for many of the women. Problems were reported around pre- and post-test counselling which was absent for three women, and often surrounded the diagnosis of a loved one (child, husband or partner). Most women were first seen as in-patients (when disease progression was extensive) or when their partners or children were in-patients. Despite offers of out-patients follow-up, only four HIV + ve women attended, three of which were irregular. A group of ten women were only seen indirectly when provision of care wasgiven to their children. A consistent group were seen with worries about HIV (either due to sexual contact with a known HZV+ ve or at risk individual) or to unfounded concerns often reflecting underlying psychological problems. This paper explores the counselling challenges of AIDS and HIV for women.     

Beyond resolution of presenting issues: Clients' experiences of an in‐house police counselling service

The availability of counselling services for employees has expanded significantly in recent years. However, despite an increase in appreciation of the value of counselling within the police service, there has been little research into the effectiveness of counselling with police personnel. The present study assesses an in‐house counselling service provided by the welfare and counselling department of a Scottish police force. Thirteen former clients (including both police officers and civilian support staff) were interviewed about their views on four areas of the counselling provision: how they entered counselling, the issues they brought, their experiences during counselling, and their assessment of the impact of counselling on their lives. Interviews were analysed using a grounded theory approach, which identified four main categories: initial engagement, learning by participating, experiencing moments of deep self‐examination, and moving beyond resolution of presenting problems. All of those who were interviewed appreciated the provision of a counselling service within their employment, and the majority reported that they had not only been helped to resolve their presenting problems, but had also made important gains in self‐awareness and work effectiveness. Findings are discussed in terms of implications for service delivery and future research.     

Counselling Supervision: The British context

Counselling/psychotherapy supervision is on the verge of a professional breakthrough in Britain today. Training courses are emerging, accreditation for supervisors is in progress and a Code of Ethics for Supervisors is finalised. Yet supervision is still little understood. There are few agreed definitions and certainly no agreed tasks, roles, or even goals of supervision. Conflict still abounds about whether it is more akin to therapy than to education, about whether or not it shold be evaluative, and about what areas of counselling it should cover. Supervisors are poorly trained in supervision and areas such as the legal implications and responsibilities of supervision not clear and often not even considered important. What research has been done is confined largely to United States and few attempts have been made to apply findings to Britain, e.g. how valid in Britain is the current research on Developmental Models of supervision which outline the stages through which counsellors in training travel.

Supervision is still tied to counselling theory despite its efforts to become a discipline on its own. Most supervisors in Britain seem to apply their theory of counselling to supervision setting. However, some of the conflicts are being faced and some questions raised about the future of supervision, about the kind of relationship involved, about its relationship to counselling. This article raises some current issues in the field and asks the kinds of questions that need answering before we are able to talk about a British understanding and application of counselling supervision.     

Minority stress and mental health among Dutch LGBs: examination of differences between sex and sexual orientation

Minority stress is often cited as an explanation for greater mental health problems among lesbian, gay, and bisexual (LGB) individuals than heterosexual individuals. However, studies focusing on sex or sexual orientation differences in level of minority stress and its impact on mental health are scarce, even more so outside the United States. Performing secondary analyses on the data of a Dutch population study on sexual health, the present study examines the robustness of the minority stress model by explaining mental health problems among men and women with mostly or only same-sex sexual attraction, and men and women who are equally attracted to same-sex and opposite-sex partners in the "gay-friendly" Netherlands (N = 389; 118 gay men, 40 bisexual men, 184 lesbian women, and 54 bisexual women). Results showed that minority stress is also related to mental health of Dutch LGBs. Participants with a higher level of internalized homonegativity and those who more often encountered negative reactions from other people on their same-sex sexual attraction reported more mental health problems. Such negative reactions from others, however, had a stronger link with mental health among lesbian/gay than among bisexual participants. Openness about one's sexual orientation was related to better mental health among sexual minority women, but not among their male counterparts. Suggestions for future research, implications for counseling, and other societal interventions are discussed.     

Executive Career Counselling

Executive career counselling is relatively new. Some of its implications are examined and a three-tiered approach by organisations is advocated. Executives are verbally fluent, and this highlights the importance of the 'opening paragraph' of words they use in counselling. Neuro-linguistic programming offers a useful set of tools to the executive career counsellor. Left-handedness, probably overlooked in most types of counselling, is briefly considered. However, counselling is not only about problems, but also offers executives a welcome chance to review their lives and careers.