1. Workshop 1b: Relationships do they change because of a stroke? Peter Saddington and Alison Towner

2. Relationships and Strokes Peter Saddington Alison Towner Sex and Relationship Therapists

3. A time of Change  Transition  Thinking about relationship  Thinking about the family  What next?  How do we talk about this?  What can we do?

5. Reactive Depression You are:  Going Through major change like bereavement or redundancy  In the morning you feel  Overwhelmed by your circumstances sad or even tearful. You feel disbelief and sometimes anger  What you tell yourself  I can’t believe this is happening: Why me? I’m falling apart. Everyone else copes. I’ll never get another partner/job/home. I’ll never be well again. My life is over  Risk of full-blown depression  It is perfectly normal to be upset by stressful, negative life events. Usually these feelings will pass. If however you feel you’ve been down too long, it might be helpful to seek advice  What you need to do  If feelings seem to be getting worse, you may need help to arrest the negative mood Discuss what has happened with your GP who will offer  you advice on medication and whether a talking therapy would help.

6. Psychological Depression You are  Having health problems, Issues to do with health  In the morning you feel  Tired sometimes despite having slept. Overwhelmed weak, tearful and frightened  What you tell yourself  What’s happening to me? I feel strange can’t cope: I feel ashamed: I’m weak no one understands  Risk of full-blown depression  Health changes can lead to low mood but once you have established the physical cause of your symptoms your mood  should improve. The good news is that ageing is not a predictor of depression. After 45 moods tends to improve. It is age plus ill health you have to watch for depression  What you need to do  If you suspect problems with your health are causing you to feel low, see your GP.

7. Roles in the relationship PartnerPatient The Relationship Carer I’m OK, you’re not OK I’m not OK, you’re OK I’m OK, you’re OK

8. Roles  Patient – can often be bewildering can also be angry  Carer – can appear angry / frustrated likely to be worried  Partner – Can see past the changes but might also be sad

9. The family Individual couple family

10. What next? Frequent concerns:  relationship roles  personality and moods  communication skills

11. How do we talk about this?  Communication is key to coping with change BUT  About 1/3 of stroke survivors have difficulty  speaking or  understanding what others say

12. Strategies to help relationships 1. Think about everyone’s perspective 2. Consider different roles

13. Strategies to help relationships 3. Increase self-esteem 4. If present, treat depression

14. Think about your intimate relationship Prepare to communicate:  What to say (“I” phrases ):  How do I feel?  What do I want?  A good time  A relaxing place

15. Think about your intimate relationship  Find ways to hug, kiss and handhold  Plan for intimacy

16. Think about your intimate relationship It may be difficult, but you can find new ways to be intimate emotionally and physically Professional help  Relationship counselling  Sex Therapy  Family counselling

17. Discussion groups

18. Refreshment, exhibition and room check in What next?