Marital Therapy

Marriage is one of the biggest gambles of life. If the gamble works, adjustment and compromise becomes the life mantra and if it doesn’t work then divorce or extramarital affairs are the outcome. If the marriage works, it doesn’t mean it is perfect. Perfect marriage is an illusion. It happens only in Mills and Boons novels. Once the honeymoon period is over, the curtain from the eyes is lifted and a clearer picture emerges. The same spouse who seemed to be carved out with utmost perfection becomes a bundle of imperfections. Fights, arguments, negative feelings & cribbing become a rule rather than an exception. If you feel that now nothing can happen and separation is the answer, think again. If love and motivation to stay together exists and no present extra marital affairs and violence or gross untreatable mental illness exists in either of the partner hope exists.

Marital therapy is the treatment of choice when such a problem becomes difficult to solve. The problem is approached in a step wise manner through a series of sessions. These are paced as per the problems in a professional and scientific manner. Few tips are given below.

No one is 100% bad or good. If there are lacunae within your partner, there must be something good as well. You can keep concentrating on the negatives and keep feeling worse but if there is anything positive, think about it which will give at least a ray of hope to move on.

Whenever feeling low, think of all the happy memories and the good times you spent together which will not only lift away the despair but also will help you in thinking clearly.

Years of marriage results in blame game whereby responsibility for anything that has gone wrong is passed on to the other partner. Shedding away the responsibility is the easiest thing to do and takes the guilt away as well. Think again. Attacking your partner will always result in defensive reaction by the other partner, the result of which will always be a fight.

Discuss issues with your partner, things that make you happy or sad, what are your expectations, how can this alliance be improved. Communication very important; which should be done in the right fashion. If you don’t talk; you can’t talk your way out.

Realise your own mistakes and how you rectify them. Change has to be brought in both the partners so why not start from your own self. Write down your positives and negatives and do the same for your partner as well.

Imagine how it would be like to be married to your own self. Then you might be able to understand the position of your spouse better. It would also help you in understanding your own self.

Long term marriages work on strengths and not weaknesses. Concentrate on the strengths of your partner and build upon it. Concentrate your energies in constructive things around you which give you happiness.

Depressed? Dont be.

We all at some point in life we all have had periods of feeling blue. The feeling persists till the time the desired goal is not achieved or some compromise is done. Depression is a feeling state which persists over a long period of time causing disturbance in thinking, behaviour, feeling, biological functions, interpersonal relations and psychosocial functioning.

Depression is such a common problem that sometimes it is referred to as common cold of psychiatry. The depression may be unipolar or bipolar. It may be endogenous or exogenous. The cause may be either internal or external. There is imbalance of neurotransmitters in the brain. Sometimes the environmental conditions may be so harsh that inability to cope up may result in depression. The range of severity may differ from mild, moderate to severe. There may be prolonged periods of feeling sad, loss of interest in the self, world and the environment. There may be severe loss of energy and initiative taking. The guilt feelings can be extreme. The perception of the world becomes negative. Biological functions like sleep, appetite and sexual performance may deteriorate and in the extreme state, suicide may be sought. In psychotic depression, there may be extreme immobility and the patients may experience hallucinations and delusions as well. The contact with reality may be lost.

The treatment depends upon the severity of the condition. There are a lot of misconceptions ignorance and regarding treatment leading to a lot of unnecessary suffering and loss of productive time. Depression is not because of lack of effort from the patient. Don’t get angry if the person cannot be positive despite ‘instructions’.

In mild or moderate depression, the patient is managed either with Medications or Psychotherapies, with medications becoming more important as the severity increases. In severe depression, hospitalisation may be required whereby the patient is managed with medications. The medications given are very safe and effective if taken under proper supervision. These do not cause dullness and do not make a person lethargic. These are also not addicting or causing dependence. And the treatment results are most encouraging.

Anger Management

Anger is an emotion related to one's psychological interpretation of having been offended, wronged or denied and a tendency to undo that by retaliation.

Being angry is not always bad. Anger is a normal human emotion, which prepares a person for dealing with the anticipated threat. Anger becomes a problem when due to various factors it becomes excessive, persistent, poorly controlled and starts interfering a person’s usual routine or social life.

Anger Management Therapies are tailor made as per the requirements of the clients. The personality, psychological mindedness of the clients, perspective on life and how the client has led one’s life is all crucial for determining the progress of therapeutic intervention. The number of sessions depends upon the severity of the problem. It can range from 5-10 sessions with adequate spacing in between.

Cognitive Restructuring is the treatment of choice. It is the process of guided self- discovery whereby the client realises that anger is just one of the many responses that can be given to any dissatisfying situation. Anger is felt when some goal is not achieved, things do not function the way they are planned or when dissatisfaction is felt over one’s life. The result is frustration and subsequently anger is felt. In Cognitive restructuring the clients are made to see the power of cognition as to how it can affect behaviour either positively/negatively which thereby determines the consequence. Cognitions are nothing but the belief system of the client. The situation is not held responsible for the action but the thoughts and beliefs are. One experiences anger and expresses it because there is fear of loss of control over the situation. This inability within oneself to tackle the situation fruitfully is hidden behind the facade of getting anger and hiding the insecure selves. So belief is generated within oneself and the clients are made to realise that they are not passive recipient of the harsh environmental forces but with ones beliefs, can change the consequences. Clients are made to realise with the help of techniques of Reflective listening, Motivational interviewing, Socratic questioning and empathetic understanding that anger at some point can serve some functional utility but if crosses the threshold then can be self destructive and debilitating. Other better options also exist which the clients fail to see which are then made more visible therapeutically. If one changes the belief regarding a situation and doesn’t feel threatened, then the consequences can also change.

A-B-C Model of anger management works by the understanding that the anger is a behaviour which has antecedents (i.e. the situations and conditions leading to Behaviour of being angry) and consequences (i.e. the after-effects of anger, e.g. being angry repeatedly can further sour a strained relationship, increasing chances of being angry). By manipulation of these antecedents (e.g. by trying to repair a strained relation) and consequences(e.g. delaying an angry response) in such a way that decreases the likelihood of thebehaviour of being angry.

Stress Inoculation Therapy is an option too, where the clients are inoculated against stress and trained to deal with stress effectively as the need arises. Anger is just one of the responses to frustration.

Mindfulness training where clients are trained towards self awareness and understanding that both good and bad are parts of the big picture and not isolated phenomena, leading to less violent reactions.

Metacognitive therapy is a higher order form of therapy where clients are trained to think about one’s own thoughts and to develop discrepancy between self owned thoughts. The clients can see, as a result, the fallacies in one’s own thinking process.

Other techniques are also taught which helps the clients to channelize their anger more productively. When in anger, analogy is given of a traffic signal. The clients are encouraged to “stop, look, think and act” which when followed can save oneself from accidents. Withholding ones immediate response can give some time to think and this can save oneself from impulsive decisions. One can drink a glass of water or box out ones anger on the bed are probably withdraw from the situation which can at least bring some momentary relief.

ANGER is only one letter short of DANGER

Weight loss: The Psychological Aspect

Dealing with weight gain is one of the most difficult psychological tasks. Many people might not agree with this but having consensus on this issue is not the aim. The intention with which this piece is written is just to inculcate hope and motivation regarding one’s ability in dealing with their own body.


There are a lot of issues associated with weight gain which is why loosing weight is regarded as a psychological battle rather than a physical one.

Self image which is derived primarily from body image is an important facet associated with person perception which our opinion is regarding our own self. How others perceive us also forms an important part of self image which largely determines our self esteem. Having an appropriate body weight is considered attractive. The day you look good is the day you feel good. If you feel good, self confidence shoots up and vice versa. Slow weight gain is like slowly losing control over one’s body and involuntarily surrendering oneself. Slowly we sit in silent and magical anticipation that a day will come when we will be able to fit ourselves in the old jeans. But obviously that day never comes. Sizes sought after are mostly L or XL with just cold sighs towards the S or M range. Dining outside is always associated with severe guilt which is compensated for by missing the next day breakfast or lunch and suffering perennially from hunger pangs. The taste of biryani is forgotten, cold drinks and meethi lassis are replaced by cold water. Mangoes and bananas are replaced by water melons, oranges or grapes. Wardrobe slowly is overflowed with baggy like clothes and good fitting clothes are said bye-bye to. One avoids fridge as if it contains some infectious microbes which will contaminate you permanently .The routes are changed so that the favourite sweet shop or junk food outlet is not crossed. One remains always hungry and frustrated. The results are either bulimic munching or anorexic dieting. Eventually long term outcome is loss not of those extra kilos but of self esteem, self confidence and happiness .

But the belief in oneself that one has control over one self is like half the battle won. The golden rule behind weight loss is not exercise primarily but PERSEVERENCE and MOTIVATION. These important traits are responsible for any act whereby long term goal is expected. Shedding those extra kilos is not impossible task nor does it require the help of those weight loss pills or slimming centres which claim weight loss of 3-5kgs in a short time. It results in more harm than good. If one is motivated enough to realise ones goals, there is no stopping. Motivation to shed those extra kilos will act as a fuel to the fire and if it is backed by perseverance then the aim is not far reaching any more. Usually time is taken out for all the important tasks except exercise. Remember that you are important, all the work and the world can take a back seat. If you can’t love or take care of your own self, how can you love or take care of others. Respect your own self first. Give yourself priority. In 24hrs, take out at least ½ hr for exercise. You can dance, do aerobics, cycle, treadmill or walk, do yoga or whatever form of exercise you prefer. Fix this time. Use music to make it enjoyable. Every mobile phone has got this option. Whatever you do, just do it regularly. Sunday can be an off day.

PATIENCE and HARD WORK is the key to success. Just give yourself a time frame and aim at loosing 5-6kgs. It is not a question of a month or two; it might take a year, so just keep going on. Something which you have nurtured over all these years like your own baby will take some time to shed away. Do not weigh yourself every day. Just hide the machine and weigh yourself once a month. It is very much acceptable that you do not loose even an inch in two months. Every machine takes some time to pick up momentum. Our body is the most astounding god made machine. The resistant extra kilos which have accumulated over all these years will take some time to go. When you invest your money, the long term investment pays higher dividends. Similarly you are investing time in your body, returns will take some time. After first three months of regular and rigorous exercise, returns will be visible. The body will be more toned up, mood will be fresh, and probably one or two kgs are lost. From there on, aim at loosing 1 kg per month. If the weight loss is slow, weight gain will also be slow. But never over do. Listen to your body.

Accompanying this is the right kind of DIETARY HABITS. Do not avoid healthy food like rice, roti, fruits, vegetables or non veg. The amount needs to be monitored. One can avoid excess oil, unsaturated fats, red meat, artificial beverages etc. People often stay hungry while dieting which should not be done. Where will you get the energy from to exercise? You should be found on the treadmill or park and not on the hospital bed. Eat everything but in moderation. Never skip breakfast, that’s the most important meal of the day. Avoid paranthas, eat roti instead or brown bread. Never push out anything completely from your diet like sugar or rice or meat etc. When you restart all these things, you gain more rapidly. Our body requires all these things including fats. You can even treat yourself to your favourite sweet or dish or can dine outside after a week. Eat small portions more frequently rather than following thrice a day meal plan. Eating in short intervals will kill the hunger pangs and the amount of food intake for the next meal will be reduced. The cravings will also reduce. Along with your body one has to take care of one’s face as well. Do not loose the lustre of your face in the race to shed off those extra kgs. Facial will improve only outside skin. If the skin is healthy it will show.

Be REALISTIC in your aim. One has to decide how much is extra and this goal has to be realistic. Every body’s body chemistry is variable and therefore the response to exercise differs. Be realistic in the amount of weight you want to loose. Do not expect drastic results. Do not aim at size zero as well. Every body’s tendency to loose or gain kgs is variable. Stop comparing yourself to your friend who has followed the same diet plan as yours and doing the same set of exercise yet has shown better results than you. Whenever your hope start diminishing or motivation starts dwindling, thing of what you will look like after 6-7 months, the feeling of getting back into your old jeans or eating as much as you want, is motivating enough.

“Every time I feel like exercising, I lie down till the feeling passes”, if your life mantra is this.....then you do not need anything but motivation.