In all forms of therapy, I am very insistent we establish a contract containing a clear set of goals from the outset. For sex therapy this would be: “Over x number of sessions to use a mixture of behaviour modification techniques and supportive counselling to re-establish your libido or to know the reason why”. But “counselling” is different from “advice-giving” and has to be sought voluntarily on the part of the client or no result can be achieved. The magistrates in Gloucestershire who recently sentenced a violent husband to “six months’ marriage counselling” didn’t know what they were talking about and nor will the hapless counsellor who has to take him on.
But how can you know when a more involved form of therapy is right for you? Try these dilemmas:
Your best friend has been married for 15 years. She’s smart, well-groomed and runs a busy home. Then she tells you the truth. She’s never really been in love with her husband and wants a break. They don’t have much sex. Her dream is to be alone in a small flat, study for a teaching diploma and hold parties. She knows her husband loves her but it is a very controlling experience – she has no personal cash or a bank account. As you talk, she sounds like a teenager with an identity crisis. Do you suggest a holiday or should she see a counsellor?
Your partner is working all the hours God gives. Under his eyes there are thick black shadows. His hands shake. He talks a million miles a minute or suddenly falls quiet in the middle of a sentence. Yesterday, he stepped off the pavement in front of a bus and nearly got killed. He says his mind is “in a dream”. His plan is to make enough money to retire at 50 but you’re increasingly worried he won’t survive that long. You personally feel neglected and fed up. Should you get him to see a counsellor? Should you go with him?
Your teenage nephew spends all day asleep and half the night playing moody music in his room. At 15, he’s got to be up for school by 7.45. Most mornings he has a sore head and a worse mouth. When you talk to him he says life isn’t worth living. The question for you is does he need help? If so, should you get your sister to offer him medicine or counselling?
These are all common problems – taken (with protective changes) from ex-clients.