Silva Neves

Silva Neves
Psychosexual, Relationship and Couples Therapist

Sunday, 7 June 2015

I love you so don't tell

I love you so don’t tell

Child sexual abuse has been reported and discussed in the news recently. So far, the debate has centred on public figures who have sexually abused children and organisations which have enabled such abuse to take place.

This is, of course, a very important debate, which brings forth the horror of childhood sexual abuse. But it is also important to remember that child sexual abuse does not only happen in such a way. Most child sexual abuse happens behind closed doors, within the family.

A study conducted by the NSPCC revealed that 70% of sexual offences against children were perpetrated by abusers known or related to the victim. 93% of victims under the age of 18 know their attacker.

Child sexual abuse involves the abuse of power, the exploitation of the vulnerability of the child and the sexual arousal of the adult. The majority of child sexual abuse goes unreported with no prosecution. International research studies indicate that between 60% and 90% of child sexual abuse never comes to the attention of the police.

A recent UK study published by the NSPCC showed that 1 in 9 young adults between the age of 18 and 24 had experienced ‘contact sexual abuse’ during their childhood. In another NSPCC study published in 2000, 72% of sexually abused children did not tell anyone at the time and 27% told someone later. 31% still had not told anyone about the abuse by the time they reached adulthood. Because most child sexual abuse goes undetected, these statistics are potentially largely underestimated.  

Although discourse around sexual abuse has become more prevalent in the media, disclosing sexual abuse perpetrated by a relative who was supposed to love and care for you remains very challenging. In my opinion, child sexual abuse will continue to go unreported and undetected because of its traumatic nature.

The clients I see do not come to me saying: ‘I have been sexually abused as a child’. They come to me for sexual problems or perhaps because they find it impossible to connect and be intimate with a partner, or perhaps because they have an aversion to sex, etc. Sometimes a history of childhood sexual abuse emerge as my clients talk about their problems.

The impact of child sexual abuse in adult survivors are:
1- Low self-esteem or self-hatred

2- Depression

3- Guilt, shame and blame. Survivors often feel guilty because they think they attracted the abuser, or they made no attempts to stop it. They can also feel a lot of shame because they experienced physical pleasure when erogenous zones were touched.
Sleep disturbance. The trauma of sexual abuse may create a lot of anxiety, which disturbs sleep. The bedroom may also be a traumatic place if the abuse occurred in the child's own bed.

4- Lack of trust for anyone. Many survivors were betrayed by the very people that were supposed to love and care for them (family, teachers, etc.) who insisted they loved them even whilst abusing them. It is not surprising that learning to trust someone as an adult can be extremely difficult.

5- Re-victimisation. Many survivors find themselves in abusive relationships or dangerous situations.

6- Flashbacks. Many survivors re-experience the sexual abuse as if it were occurring in the present moment. This is usually accompanied by images of the abuse. These flashbacks are often triggered by an event, every day actions such as the touch of a hand, or smells that remind the survivor of the sexual abuse.

7- Dissociation. This is a process where the mind detaches itself from the experience because it is too much to process at the time. This loss of connection to thoughts and feelings is a coping mechanism, but it can affect the survivors' life by repressing feelings.

8- Sexuality and intimacy problems. Many survivors have to deal with the trauma that their first sexual experience was an abuse. Survivors can have sexual dysfunctions such as vaginismus (impossible to have penetrative sex), erectile dysfunction, sexual shame. Gay men who have been abused by men in childhood may also experience a lot of shame about their sexual orientation. Heterosexual men that have been abused by men may feel that their masculinity has been compromised. Survivors also experience difficulties being intimate with their partners as adults.

Adult survivors of sexual abuse use coping mechanisms to attempt to soothe their trauma. Some of the coping mechanisms are:
1- Grieving for a childhood that they never had: innocence, nurture, warmth, safety, positive relationships with family members. During their grieving they may experience deep sadness, jealousy and intense anger. These feelings may go inwards (self-hatred and depression) or outwards (blaming their partners, projecting anger onto others, pushing people away in order to avoid intimacy).
2- Alcohol and drugs. Substances can act as an escape from intense feelings, especially when experiencing terror and helplessness.
3- Eating disorder. A compulsive control of food intake can be a way to take back control over their body,  the control that was denied in the abuse.
4- Self-harm. Burning or cutting the skin are some ways for a survivor to relieve intense anxiety triggered by memories of the abuse. 

As a psychosexual and relationship therapist, I often work with the trauma of sexual abuse, and I have seen change and healing happen before my eyes.
It is important not to stay silent. It is important to heal. Healing is possible. When it happens, it is the most precious gift that you can give to yourself and an act of love to your body. 

Originally published by Silva Neves in August 2014

Being Hyper Sexual

Being Hyper Sexual

Public awareness of sex addiction is on the increase. Sex addiction is a condition that has not been diagnosed nor treated until recently. Diagnosis and treatment started only in the 80’s with the ground-breaking research of Dr Patrick Carnes. The film Shame (2011) brought sex addiction to the awareness of the public, and more recently Thanks for Sharing (2012) and Nymphomaniac (2013).

Sex addiction is still a misunderstood condition. Clinicians are confused about sex addiction, as is the general public. I have seen many people suffering from it and heard their pain and their despair. For me, there is no doubt that sex addiction is a real and profound problem. Many people feel that their sexual behaviours cause problems but it is hard to know how to think about it and where to go for help. I hope this blog will answer some of those questions.

What is sex addiction?
Because sex addiction is only new in the public consciousness, the subject is surrounded by myths. First, let’s look at what sex addiction is NOT.
It is not about sex.
It is not fun.
It is not having a high sex drive.
It is not having lots of sex.

Sex addiction is:
1- Using sex as a primary way of coping with the unpleasant feelings of life: feeling sad, feeling angry, feeling tired, feeling bored, etc…
2- A sexual behaviour that is compulsive and repetitive. Someone with sex addiction cannot stop their sexual behaviours even though they might want to. They feel they have no control over it.
3- It makes the person feel bad. Sex addicts report that after the compulsive sexual behaviour, they feel depressed or worthless.
4- Engaging in sexual behaviour that is against an individual’s own moral values. For example, having sex outside of the marriage, even though they love their spouse.

What are the typical behaviours of a sex addict?
1- Compulsive use of porn (with or without masturbation)
2- Compulsive anonymous hook-ups (meeting online)
3- Attending strip clubs frequently
4- Visiting prostitutes and ‘sensual’ massage parlours frequently
5- Compulsively cruising places known for hook-ups’
6- Constant objectification of others
7- Using seduction techniques frequently
8- Pushing boundaries: viewing ‘no’ as a challenge
9- Multiple affairs or anonymous infidelity
10- Compulsive sexting, abusing social media networks, virtual sex (webcam, etc…)
11- Crossing professional boundaries
12- Compartmentalization: living a double life.

If sex addiction is not about sex, what is it about?
Sex addiction is about trauma. It serves the purpose to soothe deep emotional wounds left from a trauma or a series of traumas which occurred in childhood, usually.
The research of Dr Patrick Carnes reveals that:

    - 87% of sex addicts describe their familial upbringing as ‘disengaged’.
    - 97% of sex addicts report an early childhood trauma (usually childhood abuse).
    - 42% of sex addicts have a cross-addiction problem with chemical dependency.
    - 38% of sex addicts also have an eating disorder.

Because sex addiction is a trauma response, it is prevalent in all socio-economic classes, religious communities and sexual orientations. In fact, untreated sex addiction escalates. It is not uncommon for men identifying as heterosexuals to have sex with men at the height of their sex addiction. It is not a sexuality identity problem, it is the escalation of the addiction crossing gender boundaries.

You will find a listing of sex addiction specialists on the website ATSAC (Association for the Treatment of Sexual Addiction and Compulsivity):

Sex addiction is a serious condition which can cause tremendous pain for both the addict and the partner. It can escalate to levels that can be extremely harmful and can even kill. Sex addicts and their partners can feel extremely hurt and hopeless. But there is hope for both the addict and the partner, because there is specialist help available all over the UK and internationally.

Originally published by Silva Neves in July 2014. Also published in the Autumn 2014 edition of Fidelity, the journal for The National Council of Psychotherapists. 

Wednesday, 3 June 2015

Balancing Life

Balancing Life

In the recent news, we have witnessed great talents succumb to an early death because of addiction: Amy Winehouse, Whitney Houston, Michael Jackson, Philip Seymour Hoffman, and the latest casualty is Peaches Geldof who overdosed at the young age of 25.

Addiction is a widespread problem, not only amongst the rich and famous but also with people just like you and I.
In this blog, I’m going to attempt to explain the different types of addiction in general terms and also to provide some clarity as to what causes and sustains addiction.

There are two types of addiction, one that we call ‘substance addiction’ and another that we call ‘process addiction’.

Substance addiction includes: 
·  Illegal drugs

·  Prescription drugs

·  Nicotine

·  Alcohol

·  Food

·  Sugar

Process addiction includes:

·  Gambling

·  Sex

·  Shopping

·  Porn

·  Internet

·  Video gaming

·  Why do people get addicted?

Of course, the subject of addiction is very broad, and I won’t be able to give a detailed answer to this question. But I will attempt to give a broad answer to a broad question:
People get addicted to regulate their moods and achieve homeostasis: to remain stable and constant with their brain chemicals. The function of addiction is to either arouse feelings and emotions or to numb them.

Substances and behaviours that are arousing include:

·  Cocaine

·  Over-exercising

·  Pornography

·  Nicotine

·  High stakes gambling: poker games, roulette, horse racing

·  Video games (especially those that are either sexual or violent)

·  Seeing prostitutes

·  Sexualisation of strangers

·  Caffeine

Substances and behaviours that are numbing include:

·  Opiates

·  Benzos

·  Narcotics

·  Over eating

·  Masturbation

·  Alcohol

·  Gambling to achieve a trance-state like: slot machines or lottery

·  Heroin

Ecstasy and MDMA are substance commonly used in Britain. They can be both arousing and numbing in rapid succession which creates an imbalance in the brain chemicals. 

People who are addicted to a substance or a behaviour in order to achieve homeostasis through the arousal or the numbing of emotions, activate a neural pathway of fantasy. I hear addicted clients say that they want to ‘escape the world’ because they find the stresses of life difficult to cope with. 

Of course, having fantasies is healthy. We all have an ability to fantasize for a good reason: it gives us purpose. It gives us coping strategies. It cultivates our creativity. It can make sex meaningful and fun. 
But some people can get stuck in the fantasy cycle because the addiction blocks the exit. Exiting means to return to reality, which is often a state that can be perceived as ‘dangerous’ for the addict. 
This is because what they are trying to avoid is a much deeper, more painful state: shame.
Shame feeds the addiction and it is the motor that keeps the addiction going round and round in the cycle of fantasy. 

All addiction can be fatal. Substance addiction can be fatal when someone takes an overdose. Process addiction can lead to someone losing everything: marriage, children, house, job, etc… When some people hit ‘rock bottom’, they feel so desperate and depressed that they often commit suicide or self-harm. 

All addiction can make people feel isolated; they engage in behaviours that are deceitful to protect their addiction (lies, rationalisation, etc…).They protect their addiction because it is very important to them: it is their primary way of regulating their moods. Without it, they feel they would fall apart. 

Part of the therapy is to find ways to regulate moods in a healthy way to replace the addiction. It is often a long and bumpy road, but recovery through the therapeutic process is good and permanent. The client learns how to balance life with a new lifestyle, whilst learning how to tolerate the uncertainty of life (anxiety reduction). 
Towards the end of the process, clients start to feel grateful for themselves and those around them. They start to love themselves and are willing to be seen as imperfect, vulnerable and worthy people. 

If you or a loved one has an addiction, contact a therapist specialised in addictions. Remember, there is help and there is hope. 

Originally published by Silva Neves in June 2014

From Shame to Grace

From Shame to Grace

On March 28th 2014, the UK legalised equal marriage. The first same-sex wedding ceremonies were performed at the stroke of midnight.

It was only in 1973 that The American Psychiatric Association (APA) de-categorised homosexuality as a mental illness. Since then, the journey towards acceptance has been long and arduous. Today, the gay community can celebrate significant progress. Same-sex couples are now accorded marriage rights equal to those of their heterosexual counterparts. Couples can now have the equal ‘married’ status, the same as heterosexual couples.

However, it is important to remember that the global struggle is far from over. In so many countries, being gay is not only illegal but is an offence punishable by death.
Clients who came to Britain to escape such countries said:

‘My mother would rather die than have a gay son’

‘I bring the worst disappointment a man can bring to his family’

‘My soul is crushed each time I think about being gay’.

For these clients, coming out to their family is not an option:

‘If I came out, a family member, probably my uncle, would come to London, find me and kill me’.

It is admirable that the UK has opened its doors to asylum seekers facing death on the grounds of their sexual orientation. However, we don’t have to go far to find homophobic behaviour, as it happens right here, in Britain, too.

Although laws can change overnight, just as it happened with marriage equality, the personal view of people is much harder and slower to change. There is still much discrimination in the UK based on sexual orientation.

As a minority population that is experiencing discrimination, it is not surprising that a large number of gay people seek professional help for depression, self-harm, addiction and suicide attempts.

Some of my clients that are openly gay with their family, friends and work colleagues still experience struggles because, as one client said: 

‘We live in a straight world’. 

What does this mean for gay people?
We always hear about ‘coming out of the closet’: revealing your sexuality to mum and dad. Indeed, coming out to your parents is one of the most frightening prospects because there is a huge risk of being rejected and abandoned by the family. In some cases, there is even a risk of violence. But to assume that once you’ve come out to your parents everything will be fine is simplistic.

As ‘we live in a straight world’, gay people are constantly ‘coming out’, throughout their lives.

One client said: ‘Only a few days after I started my new job, a colleague asked the awkward question: do you have a girlfriend? I was paralysed for a second. What do I say? Do I lie? Do I say something really vague? Or do I tell the truth? Well, I decided to come out and I said no, I don’t have a girlfriend, I have a boyfriend. And then, I was faced with a stereotypical clumsy response. Oh really? You don’t look gay because you’re manly’

Another client said: ‘when we moved flat, it was obvious that we were a gay couple. I mean, you know, we both got communal stuff out of the van into our one bedroom flat. It was a sunny day. People were out. Neighbours were out. They looked; some with a smile, some with a frown. I suppose that was our neighbourhood coming out done right there and then!’

Now that equal marriage is legal, being able to call your same-sex life partner ‘wife’ or ‘husband’ is, I believe, a wonderful step forward. But it will take time before the ‘coming out’ process becomes obsolete.

In my work with gay clients, I have found that there is a lot of shame around sexuality, often unconsciously, because when growing up they absorbed homophobic messages: 

‘If you’re not good at sports you’re a sissy’

‘Gay people are disgusting’ 

‘It’s not normal to be gay’. 

This is emphasised by the language of school pupils. Calling something ‘gay’ is done so pejoratively, suggesting that something is faulty, broken or worthless. 

As well as the homophobic messages absorbed throughout childhood, gay people often feel different from their school peers. 

A client said:‘How could I argue with my bullies? They called me a poof, and I knew deep down that I was one’. 

Sometimes, that feeling of being different happens in the pre-pubescent years, long before the person has any ideas or understanding about sexuality. This feeling of being different translates into the subconscious with a message similar to: ‘I am wrong’. And this message is the seed of shame. 

Beyond school, when the gay man grows up and starts to acquaint himself with the gay scene, new confusing messages start to appear. The gay media is mainly concerned with looking young, looking gorgeous, partying and being a sex god. 

Clients say: 

‘I go to the gym seven days a week, for two hours each time, and I still don’t look right’

‘I’m afraid I will lose my erection and that would be completely unacceptable’ 

‘What is there to gay life? You work and make money, then you spend your money on designer clothes, personal trainers, clubs, drugs, having a good time at the weekend, and then you start your week all over again’

‘I have great friends. I have an accepting family. But I feel so lonely because I’m not like all the other gay guys out there. I don’t like clubbing and I don’t go to the gym’

It can be very difficult for gay people to find their sense of self. There are no alternatives to what it is like to be gay other than the confusing messages of the gay scene. If you feel you don’t fit into these restrictive gay stereotypes, then, what else is there? A lot of my clients think there is nothing else. And this taps into the inadequacy felt in childhood and grows into significant shame. 

This unconscious shame is often prevalent in the choices that gay people make in adult life. One of the main problems that my gay clients come to me for is that they feel unable to start, build and maintain an intimate relationship. They put themselves at risk by practising unsafe sex. They developed an addiction or multiple addictions. They experience sexual dysfunctions such as erectile problems. They feel lost, unhappy and depressed.

It can be a challenge to be gay in a straight world. But, with psychosexual and relationship therapy, gay men can rebuild rewarding and fulfilling lives. Nurture can replace shame. And, eventually, they can move from feeling stuck and isolated to planning their wedding day with the love of their life. 

Originally published by Silva Neves in May 2014.
Also published in, website by 56 Dean Street clinic.
Also published in Fidelity, The journal for the National Council of Psychotherapists, Spring 2015.

When Sex Doesn't Work

When sex doesn't work

A lot of people think that having sex should be easy and should happen without even thinking about it. Therefore, when sex doesn’t work, it leaves people feeling ashamed and broken: ‘why can’t I do this normal and natural thing that everyone else seems to be able to do?’

Our sexuality lies at the core of our being. We are born with it and we develop it from the moment we are born. This means that sexuality is complex and, therefore, having sex is a complicated act.

When one has sex, it is not merely the exploration and union of two bodies. We bring in bed with us our morals, our judgements, our core beliefs about ourselves, our beliefs about being a man or a woman, what it means to us to be sexual in some particular contexts, our fears and hopes, and what we believe about the partner(s) we are having sex with.
Growing up, we constantly receive messages about sex, and, as children, we have to make sense of those messages.

Consider the following scenario: a boy grows up in a home where sex is never talked about. When there is a sex scene in a movie on television, he witnesses his parents hurrying to the remote control to change the channel. The message that the boy will understand from this is ‘sex is wrong’, ‘sex is shameful’, ‘parents do not approve of sex’. Then this boy ends up in a changing room at the end of PE and is teased by his peers because he has a ‘small penis’. This increases his shame and a feeling of inadequacy towards his peers. In time, the boy develops and goes through puberty. He finds himself with a sexual partner for the first time. He feels extremely anxious because it is his first sexual encounter, and his partner is likely to also feel extremely anxious. Because of the anxiety, he doesn’t manage to get an erection. This event is especially devastating for a man, because it makes him question his sense of masculinity and results in tremendous shame. The second time he attempts to have sex, he will feel twice as anxious as the first time and the likelihood is that he will not have or maintain an erection then either because of the compounded anxiety and shame. 

Now, let’s look at this scenario: a girl grows up in a family with parents shouting at each other all the time. She learns the message ‘relationships are bad or painful’. Then, at school, she is teased by her peers for being overweight. This is deeply shameful. The girl grows up and becomes a teenager. Her body changes massively in a short space of time. Her parents are too busy arguing with each other to notice the changes, and nobody talks to her about becoming a woman. Going through this process of change with no support or information can be very shameful and painful for a young teenage girl. She will ask herself some questions about her body: ‘Am I fat?’ ‘are my breasts too big?’ ‘how do I manage my periods?’, and so on. When she finds herself with her first sexual partner, she is full of anxiety. Because of the anxiety she finds penetration very painful. She dissociates and tells herself that the first time is always painful but she feels a lot of pain the second time and the third time too. This results in tremendous shame because she feels she has let her sexual partner down. She feels she might be ‘frigid’ or ‘less than a woman’. This increases the likelihood that each time she is in a sexual situation she will fear the anticipation of pain so much that anxiety and shame will continue to increase. 

These, of course, are only simple examples; there are very many other experiences that may contribute to sexual difficulties. The main issue I would like to stress is that when sex doesn’t work it is because most people find it difficult to talk about it. In turn, the less it is talked about, the more there will be shame around the issue. 
It is often not possible to talk about sex with parents, teachers, peers and even some therapists. 

If you experience a sexual problem, it is important to consider the following: 
Firstly, is my sexual problem due to physical factors? It is very common that sexual dysfunction is linked to a physical cause. For example, erectile functions can be affected by a heart condition, diabetes, some medications, low levels of testosterone, and so on. 
Painful vaginal intercourse (dyspareunia or vulvodynia) can be caused by hormonal contraception, an allergic reaction, some medications, yeast infection, pelvic floor dysfunction, and so on. 

I would recommend that if you suffer from any sexual problems that you ask your GP to carry out the necessary tests to find out if there is a physical problem. 
If there are no physical causes found, you can safely assume that your sexual dysfunction is of psychosexual cause. 

Your second step is to look for a therapist. As mentioned above, some therapists are not comfortable talking about sex. It is therefore important that you look for a therapist that is specifically trained in psychosexual issues. The best place to look for a trained psychosexual therapist near you is through the website: 

Psychosexual therapy (also called sex therapy) combines a behavioural approach (learning new tools and habits for better sexual functioning, through specific exercises assigned to do at home on your own or with your partner) and a psychodynamic approach (the exploration of the childhood messages, the experiences of sexual development and your core beliefs about yourself). 

If you are in a relationship, couples therapy may be appropriate, because sexual problems impact on a relationship and vice-versa. 

The most common psychosexual problems are: 
For men: erectile dysfunction, premature ejaculation, retarded ejaculation.
For women: vaginismus (women who cannot have penetrative sex), dyspareunia and vulvodynia (painful intercourse).
For both: Difficulties with orgasms, loss of libido, differences in sexual desire within the relationship, sexless relationships, lack of intimacy. 

Psychosexual therapy is the best therapy to treat sexual problems of psychological causes. Over the decades, psychosexual therapy has proved to be successful in obtaining long-lasting positive outcomes. 

Making the first appointment for psychosexual therapy is very scary because it involves such an intimate subject, which touches the very core of our being. However, it is a necessary step towards satisfying and fulfilling sex lives and, ultimately, happier intimate relationships. 

Originally published by Silva Neves in April 2014.

Screaming and Shouting

Screaming and Shouting

Couples argue sometimes. On occasion, it is even healthy for couples to argue. We’re only human. Sometimes we say the wrong thing at the wrong time to our partner, with the wrong tone of voice. And it hurts them. And it escalates into an argument. And sometimes, couples end up raising their voices at one another for a short time. Then they make up, apologise , and move on. This is life.

However for many couples, arguments do not occur in this way. Some couples argue so frequently that they cannot remember the times when they do get on. Or when they have a good time with their partner, they cannot enjoy it because they are always dreading the end of the ‘good time’ and expecting the next argument to explode at any time. Some couples find it impossible to resolve conflicts. Once the shouting is over they are left without a resolution, the problems then fester, only to have the same problem resurface a week later with another argument.

Many people that come to see me report that the arguments are so frequent, with so little resolution, they feel completely miserable. In my previous blog, I wrote about good relationships being good for us because it boosts the immune system and is a source of happiness. By contrast, a relationship that is soaked in anger, resentment, disagreement and arguments can make one ill. My clients have reported getting frequent colds, having panic attacks, feeling muscle tension, having frequent headaches, insomnia, and sometimes feeling so hopeless they start to have suicidal thoughts. Living in such a relationship can chip away your self-esteem little by little until you lose your sense of self.

Some couples are so angry that they argue about everything: who takes the rubbish out, who does the dishes, who takes all the cover s in bed, where to go on holiday, who picks up the children from school, and so forth.

In some relationships, the anger and resentment is so deep that the breach it had created between the two partners is too wide to repair. Some people in this situation decide to leave the relationship. If this is the case, and depending on the length of the relationship, a therapeutic ending may be advisable, for proper closure.

Many people in angry relationships feel they cannot leave the relationship because, deep down, they love their partner. Indeed, they were once in love. But there are just too many arguments and bad feelings, and they believe things need to change. This is often at this point that people decide to come to therapy, either as individuals or as a couple.

In couples therapy, the anger, resentment and lack of conflict resolution between the two partners can be healed. They often learn that it is hard to fully understand the other person’s world. In fact, sometimes, it is not possible because we all experience life differently. We all have a different set of emotional responses to some events. However, by facilitating a process of therapeutic dialogue, each partner can begin to build a bridge between their own worlds and meet in the middle, free of anger and resentment.

Good communication is one of the key elements to a better relationship.

There are five easy communication tips that each partner can use to begin to decrease anger, resentment and, in turn, the intensity level of arguments:

1- Use the ‘I ’- statement. Saying ‘you’ makes you be a parental figure and will trigger a defensive response from your partner. Instead of saying: ‘you make me angry’, how about saying: ‘I feel angry’. Replace ‘you never do the dishes’ with ‘I notice the dishes have not been done today’.

2- Try to avoid words such as ‘should’, ‘must’, ‘mustn’t’, ‘shouldn’t’. It is likely that when you hear these kind of words, you will be reminded of authoritarian figures such as your parents or teachers. Again, it will trigger a defensive response from your partner. Instead of saying: ‘you should stop smoking’ how about: ‘I feel smoking is not healthy and I worry that you might get sick in the future’. Replace: ‘you must tidy up the house before our guests arrive’ with ‘I would appreciate if you could help me get ready before our guests arrive. If I cook the meal, would you be happy to clean the house?’ 

3- Listen to each other actively. When you ask your partner: ‘how was your day?’ be prepared to hear more than ‘fine’. Be curious about your partner’s life. Ask more questions: ‘what do you mean by fine? I really would like to know’. 

4- Clarify what you heard your partner say and validate it. For example, if your partner talks about a bad day at work, and you don’t have experience in the field of work of your partner, you can validate and clarify saying something like: ‘I don’t understand what it is like to have a boss like yours, but I can definitely hear that it is very hard on you. When you say you are fed up, what do you mean? Tell me more.’ This type of conversation is not about an attempt to fix things for your partner or make things better for them, it is only about being curious about your partner’s life and truly being present in the relationship. 

5- State your needs clearly. Often, couples think they can read each other’s mind. But this is not true. Couples only make assumptions, and often assumptions are wrong. Therefore, it is important to state your needs clearly to your partner. A common example is sex. When one partner initiates sex and the other doesn’t want it, if there is no dialogue, you will make assumptions: ‘I’m not attractive enough’, ‘why doesn’t he /she want to have sex with me?’, ‘is there someone else?’ However, if you state clearly what is going on, the dialogue would sound something like this: 
‘I have had a really busy day at work and I feel exhausted. I would rather sit on the sofa with you and watch television.’ 
‘You do not want to have sex with me because you are exhausted. Am I right?’ 

Another example of stating your needs clearly would be: 
‘I know it is my turn to wash the dishes, but I really don’t want to do it today. Is it ok if I do it tomorrow?’ 
‘It has been ages since we have done something nice together. I really would love going out to a restaurant sometime soon. What do you think?’ 

Often, problems of anger and resentment in the relationship are more complex than just a communication problem. Couples therapy is very valuable to look at all of the issues that may contribute to the wedge that is established in between the partners. The communication tips above can be used to start the process towards better dialogue but it is not the only challenge that many couples need to address in order to have a better relationship.

These tips seem simple, but they can be difficult to stick to in a relationship. It is often easier to get started with a new way to communicate with the help of a trained couples therapist than on your own. But, with time and effort to change the couple’s dialogue, negative emotions can be overcome. 

Of course, we’re only human , so there will be moments when you say the wrong thing at the wrong time with the wrong tone of voice, but these instances will be less and less frequent, and, hopefully, mutual intimacy will replace what once was anger and distance between the two partners. 

Originally published by Silva Neves in March 2014.

To Love or Not To Love

To Love or Not To Love

Most of us want to have the perfect date, fall in love and live happily ever after. Falling in love is such a wonderful thing. You feel so great about yourself, and about life. You think anything is possible. And you think that the person you have just fallen in love with is perfect. It isn’t surprising. At that moment your brain is soaked in Dopamine, one of the love chemicals, which, in fact, has a similar effect on the brain that cocaine has. People suffering from schizophrenia have an abnormal level of Dopamine in the brain, too. So, even though you are far from experiencing schizophrenic symptoms, and you are not suffering from the side effects of cocaine, it is safe to say that you live in a ‘rose-tinted’ world. This is why we often hear the phrase ‘love is blind’. Because it is!

Just like any other drug, the ‘come down’ comes after the ‘high’. Your brain cannot sustain such a level of Dopamine in the long term. So, eventually, it dies down. That is when you start to notice that your perfect lover is not so perfect after all. In fact, your lover has some annoying habits. And your lover is not such a great lover anymore. Your lover is normal. Human. Flawed. This is when you have a conflict with yourself: ‘My head says this, but my heart says something different… I’m confused!’ 

Then you feel like a fool. How could you have thought that your lover was going to be the answer to all your problems? The key to unlock all your potential? The answer to your happiness? Sometimes the comedown is so harsh that you decide your lover cannot possibly share your bed anymore. You break up, feeling hurt, feeling you failed. You feel angry at yourself and at the lover who disappointed you so much. Then, testosterone kicks in. Testosterone is also called the War Chemical. You are angry. So angry, that, sometimes, you cannot bear to be near your lover again. You shout at them. You break up. It’s all over. 

And then, you start your search again for the one. 

In my practice I often hear: 
‘I thought he/she was the one’
‘I’m never successful in dating’
‘I’ve never had a long-term relationship’
‘I can’t seem to be able to settle down’ 
‘Where are all the single men/women?’
‘Where do you meet single men/women?’ 

Then I hear rationalisation of the failures of relationships, which are often gender-specific and are generalisations. 
I hear women say: 
‘All men are bastards’ 
‘Men don’t do feelings’ 
‘He doesn’t understand me!’

I hear men say: 
‘All women are materialistic’ 
‘Women are always so emotional’ 
‘I never know what she wants!’ 

Most often men and women come to my practice not after one failed relationship but after three or four. And they decide to come for help because they realised that, no matter what they did with each different lover, they always ended up feeling the same, and it was always the same story being played out. They come to therapy to break free from this pattern and to finally find the right partner. 

In fact, most people seem to think that falling in love, meeting the one and then living happily ever after should be a natural thing. It should happen with no effort. And it is normal and easy. What if I told you these beliefs were wrong? 

What if I told you that falling in love is easy (thanks to Dopamine) but staying in love is hard work? Meeting the one is terrifying. And being happy ever after is quite different from how it is depicted in romantic comedies or in fairy tales. 

The truth of the matter is that if you want to meet the one, you can. The right lover for you is definitely out there! But it is terrifying because it means that you have to open yourself up to being vulnerable. 

The feeling of rejection is one of those feelings that human beings try to avoid the most. Why? Because it is a very deeply painful feeling.
Imagine that you are in a pub on your first date. You really like your date, you start to envisage what your second date might be like. But on that first night, your date tells you: ‘I had a really good time, but, actually, I think we should just be friends’. What a rejection!! Very painful! Why is it so painful? After all, both of you are adults, you’ve only just met, you will survive. Oh no… In this scenario your brain will make a connection with other rejections, some that are now so far away that they don’t belong to your consciousness anymore. Yet there are some deep unconscious triggers. Your brain will remember the very sad feeling of loneliness, utter disappointment, sadness, and inadequacy when the person at school that you have been fancying for ages turns up at the Prom with someone else. Your brain remembers the very deep painful feeling when you were five years old; you spent the day at school drawing a picture for your parents. When you presented that picture, your parents were too busy to give you the attention you deserved. Rejection!! So now, as an adult, your date tells you: ‘I think we should be friends’. You feel and you react as the five year old who had been unfairly ignored. Your pain is deep. You feel hurt, sad, inadequate, and perhaps even ashamed. 

It is therefore not surprising that human beings avoid this very painful feeling of rejection. So how do we avoid it? 
We make sure we meet the wrong people, because if we meet the wrong people, there is no loss, right? No loss means no
rejection. Right? 
So we rationalise, ‘He was crap anyway. A typical man. Can’t talk about feelings’. 
‘She was crazy. Talking about shopping all the time. So materialistic, like all women’. 
The problem is that it is the same the next time. And the time after that. 

And then we are suddenly 30-something and still single. And that is when you conjure up all your courage, and you dial my number. 

My female clients in this situation have a hard time. The biological clock is ticking louder and louder. They are afraid of ‘being left on the shelf’. All their friends have babies. 
My male clients have an equally hard time. They are perceived by their peers as lesser men because they should have settled down by now. ‘What is wrong with you? Still no girlfriends?’ They see their friends marrying, having babies and getting a mortgage together. 

Why is it so difficult to meet ‘the one’? Because you are looking for the one in the wrong place. The one is not in a bar. They are not the single person at your friend’s wedding. They are not in your online dating inbox. 

‘The one’ is inside you. 
From the moment that we are born to the present day, we experience life, and we experience life with others. Through those experiences, we learn information about ourselves. It is the way we feel about ourselves that inform whom we see. Our brain acts like a filter. It means that if we believe that all men are bastards, we will only meet bastards, disregarding the really nice one sitting just next to you. And if that really nice one comes to you and pays you a great compliment, you don’t believe them. You dismiss them. Because they do not match what your brain perceives as the ‘romantic template’. You tell yourself that this man is weird. You move away. 

If we believe that all women are overly emotional, we will miss the thousands of emotionally stable women walking around everywhere, every day. If a wonderful stable woman approaches you, you think ‘she’s got a secret agenda, she’s after something’. 

In therapy, I help my clients challenge their thoughts about their romantic template, I challenge their thoughts about love and relationships. Let’s be honest, sex and relationship education is poor in our country, so we often have the wrong information about it. And, well, there are no lessons in love either, so if you want to change things, it is important to un-learn some inaccurate information and re-educate yourself. 
With my clients, I also guide them to look thoroughly into their life experience so that we can bring to the fore what their romantic template is made of, in order to change it to a more realistic one. Most of the time, the work is challenging, because it involves letting go of some beliefs that had been held for a long time. Sometimes, it involves being vulnerable in the therapeutic setting. 

The good news is that this therapeutic process is a transformative one. Time and time again, I see clients at the end of their journey being so much happier with themselves and others. Being happy in a good relationship is very good for you! It triggers Oxytocin, the brain chemical known as the ‘well-being’ chemical. This chemical regulates your heart rate, brings down anxiety, boosts your immune system and is the best anti-depressant. It is literally good for you to be in a good relationship. 

Originally published in February 2014