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 difficulties have you experienced in 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 Work / Task Related Son Manager Mother Partner Teacher Driver Family / Relationship Work / Task Related Carer Friend Cook Gardener Lover Banker Writer Learner Internet lover Traveller Listener Dreamer Interests / Passions Personal Qualities Runner Socialite Follower Organiser Bookworm Carer

Styles of Communication Passive Direct Aggression Indirect Aggression Assertive

Direct Aggression ‘What you could do with…’ ‘How dare you!’ ‘If I were you, I’d do it this way’ ‘do as I say’ ‘I don’t give a **** about you’ ‘I always win’ Traits: Bossy Arrogant Intolerant Opinionated Over-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’ ‘Can’t you take a joke’ ‘I’m never angry’ ‘I’m surprised that you’ve managed that’ ‘Martyrdom's my way of life’ ‘You make me feel…’ Traits: Manipulative Sarcastic Deceiving Insinuating Ambiguous Guilt inducing Result: Get your own way but people back away…

Passivity ‘Whatever you want is OK by me’ ‘I’m so sorry’ ‘Nothing goes right for me’ ‘I’m waiting for my life to get better’ ‘You decide for me’ ‘I don’t matter’ Traits: Waiting Martyrdom Apologetic Indecisive Moaning Submissive Result: No responsibility for self, therefore no guilt feel resentful when others take responsibility

Assertiveness ‘I’m not perfect’ ‘I’ll take a risk’ ‘I feel…’ ‘I’m OK – you’re OK’ Traits: Open Direct Honest Positive Accepting 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 YOUR Feelings Needs Rights Opinions OTHERS Feelings  

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 Event Fish Feelings Need 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