Relationships and IBD Debbie Pullen Liaison Mental Health Nurse Liaison Psychiatry

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