Our goal is to leverage the wisdom and experience of healthcare practitioners to set you on a path of self-discovery and healing. These insights coupled with a multi-disciplinary approach to each area of interest should provide an invaluable resource to everyone looking for a better approach to health. In this episode, we speak to Ingrid Nagaya, a clinical psychologist based in Fourways, Johannesburg, South Africa. She discusses the topic of couples counselling with us, from the perspective of a clinical psychologist.
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Audio Transcription ::
Welcome to The Moulding Health Show. Our goal is to leverage the wisdom and experience of health care practitioners to set you on a path of self-discovery and healing. These insights, coupled with a multidisciplinary approach to each area of interest, should provide an invaluable resource to everyone looking for a better approach to health. In this episode, we speak to Ingrid Nagaya, a clinical psychologist based in Fourways, Johannesburg, South Africa. She discusses the topic of couples counselling with us from a clinical psychologist perspective.
Shaz :: Welcome to the show, Ingrid. Today, we’re going to be chatting about couples counselling and specifically what an amazing benefit you can get by working with a clinical psychologist on your couple’s issues. And today, we will be chatting to Ingrid Nagaya, a registered clinical psychologist based in Johannesburg. Ingrid, how are you?
Ingrid :: Fine, thanks Shaz! How are you?
Shaz :: I’m very good, thanks! I’m really excited for today’s show. So, we’re going to be chatting about couples counselling. Could you tell me a little bit more about what couples counselling is? It seems to be very vague, like I’m going for couples counselling or couples therapy, but what is it actually?
Ingrid :: So couples therapy or couples counselling is all about two people coming into a therapeutic space because there is a difficulty or a challenge within their relationship. The difference between couples therapy and individual therapy is when you come into the space as an individual. It is all about your own stuff and your own difficulties or challenges that you may have at that time and we just focus on you. When you come into the couples therapy space and therapist becomes the facilitator for the two people or three people or however many people in that relationship. So, couples or thruples doesn’t really matter. But what the therapist is then doing is the therapist becomes a mediator between the partners or among the partners.
Shaz :: Okay! So, on that note, why do people seek out assistance around couples or thruples counselling?
Ingrid :: More often than not, people come into a couples therapy space when there is a difficulty or a challenge or conflict in a relationship. Let me give you an example of conflict, if there’s been infidelity or mistrust or deceit, if they have different ideas of how they thought this relationship was going to be and they find it quite difficult to be able to work it out between themselves, sometimes they will seek a mediator. A lot of the time, the issues around physical and emotional intimacy tend to come at trauma in relationships, going through transitions such as parenthood, immigration, any kind of big move. Most often than not, I see couples around loss. For example, the loss of a child, the loss of one of their parents, or let’s say loss of employment or anything like that would take away from the homeostasis in the relationship. And they find that they can’t really find a way or figure a way out going forward. They tend to ask for a mediator to be present.
Shaz :: Okay, couples counselling is in a way there to help when there’s been a bump in the road to just kind of smooth things back out and keep going in the right direction. So how would a clinical psychologist help with couples counselling? And you guys have focused a lot more on the clinical side of mental health. So where would you be able to fit into that couples counselling space?
Ingrid :: So whenever there’s a disorder within the relationship space. For example, if one partner has a mood disorder or has some kind of a clinical condition, a mental health issue, helping the other partner through how to manage that, how to support without the relationship sustaining a huge loss is where we generally tend to step in. If there is complicated grief, which is more complex tends to go more towards disorder kind of stuff, or if the couple is battling with infertility, it requires quite a lot of medical procedures and the couple needs support throughout that space. The other reason that couples come in to see me is because of miscarriages. So how do you deal with that as a couple? The loss of a pregnancy at any stage is traumatic. So how do you deal with trauma? So that’s where I would help.
Shaz :: If a couple was coming in to see you, what could they expect from therapy? And is there a specific therapeutic plan that you would have set out for couples coming in for therapy?
Ingrid :: I work from the client centered approach. And what that means is that I don’t have a set formula for anybody. So, people coming into my space I generally will develop or try to develop a strong relationship with them, try to have a secure supportive environment and then we tackle the issues as and when trust is within the space of trust. To establish trust then is really, really important. I don’t believe that anybody, even though you may have similar difficulties I don’t believe that anybody is a replica of somebody else. I don’t do recipe therapy, unfortunately. So, I have good guidelines in terms of facilitating communication. These are the broad strokes in terms of what they are commonalities around, but it has to be a space that is based on trust and respect and facilitating communication and making sure that people are speaking in an open, authentic kind of way.
Shaz :: I love that you say you don’t have a therapeutic recipe book, everybody seems to believe that everything comes in these cookie cutter molds and forgets that everybody is different or individual. And, what works for one person might not necessarily work for person B, so I love the fact that you don’t have a recipe book of “Okay add three pinches of love”. So once a couple comes in for therapy, is there an average amount of time that a couple would remain in therapy or is this also very fluctuating depending on the circumstances?
Ingrid :: Absolutely, yes! I do believe that there are some people that come in and they only require a few sessions because really, they just need a little bit of help and then they are back on track again. But for example, if they are let’s say we talk about infertility, it’s a very complicated issue. There are multiple medical procedures and there is so much distress around, procedures not working. Is there one partner who is the contributing member to the infertility? Is there blame and guilt and shame and all of that? It’s complicated. So, unfortunately three sessions are just not going to cut it. And, I would want to support the couple through that process up until we get to the point where we have a favourable outcome. So, that would be a more longer-term kind of approach. Perhaps not speaking to the couple may not come into the therapeutic space religiously every single week without fail. It depends on as and when what is needed, but it might be a longer-term relationship overall.
Shaz :: Okay, so it is entirely dependent on obviously what the couple is going through and what therapeutic needs that they do have. Would a couple come in for more maintenance therapy? You know, we’re a happy couple and are in a good place, but we just kind of want to make sure that we stay here. Or do you find people tend to only reach out when the wheels have now fallen off the bus and they’re going, okay well! We now need to grab a lifeline.
Ingrid :: I think it’s a mixed picture, unfortunately as practitioners I don’t think we do enough work to be proactive. Especially, in the space of clinical psychology when you’re dealing with disorders you get a diagnosis and then you have management of a chronic condition. To encourage people to be proactive about their relationship in general is not a common thing, I would say. I also want to mention the fact that I actually have quite a lot of pre-marriage counselling, so when people have decided to get married or they want to make their relationship a live-in relationship. I will have counselling something to help with the transition and strengthening and building a resilient relationship or facilitate building a resilient relationship.
Ingrid :: So people don’t only come in for them having a traumatic incident or a difficulty, sometimes they do come in to preserve what they have, it’s a mixture. Predominantly I would say we have trauma that brings people in. But you get some amazing people that say, no! The divorce rate in our country’s 50 percent. Let’s not wait until there is an issue, let’s learn how to do this better.
Shaz :: Let’s not become a statistic. Let’s maintain and make sure that we’ve got the guidance and help we need and occasionally we might need a mediator in the middle. I know that’s absolutely amazing to think of it from that aspect that it doesn’t always have to be we are through trauma. It can also be, I just want a little bit of maintenance to make sure that we stay on the right track. What would a couple be able to expect during couples counselling sessions? I know you said it’s about building a space of trust and that kind of thing and that you will be the mediator but bringing up television, you often see these married couple in counselling and one of them kind of sits quietly on the side of the couch the other one ‘s going on your computer this needed this needed. So, what can a couple actually expect? Because what you see in the media 9 times out of 10 isn’t what actually happens in the therapeutic space.
Ingrid :: An indication of some of the guidelines that I set down. The first thing is, there isn’t an assumption that people are coming into my space only because they are fixing an issue. Generally, people tend to come into my space and I say okay, can you explain to me. Each person in the relationship gets an opportunity to express why they are with me. And then we set the goals in terms of what we want to accomplish in therapy. So, space where there is active listening and the ability to be able to speak without restraint and not worry too much about oh my gosh is this appropriate or is this inappropriate particularly about their own needs. That’s definitely something that they can expect. It’s not individual therapy so it’s more about being able to figure out what does the relationship need obviously when a relationship is on life support because of trauma or a difficult situation or challenge or conflict, it feels like it’s very difficult for the couple to think about why we were together in the first place or why did I marry you why do I live with you. So, some of the couples therapy space is about being able to reconnect in a safe environment, when people have lost their way from each other it’s very difficult to have an open and honest conversation because everything feels antagonistic, everything feels like threat or an attack. So that’s where I facilitate in terms of opening up the lines of communication.
Shaz :: It’s really like giving a lifeline there to help them find their way back to each other in a safe environment part of structured but not necessarily in our case we gonna go A, B, C, D. I like the fact that you mention that you set goals because then the couple knows what they’re working towards and each time they come in and how much close are they to that goal. Yeah, it gives that sense of accomplishment that we as a couple have done this together and that in a way I would assume that also kind of starts to bring that closeness and intimacy almost back to it’s not me vs you, it’s us working together to a goal. Is there any advice that you could give us a clinical psychologist the couple or person considering going into couples therapy anything that they should be looking out for or kind of thinking? Yeah, I would say anything that they should be looking out for that could be a red flag to say maybe we need to get help.
Ingrid :: I think whenever there is prolonged stress in a relationship and we’ve tried different things and not quite getting to the point where this issue is resolved, I would suggest getting an intervention. Whether it is from a pastoral counselling point of view, if your quite religious try pastoral counselling is very different to the clinical setting but having somebody who is always to mediate is the first step. If pastoral counselling doesn’t work for you or it’s not what you want to do then I would suggest marriage counsellor for sure. Simply because we’re looking for a solution but if you don’t have the tools then it is very difficult to be able to find a solution so if we do things the way that you’ve always done things and not something is broken that’s not going to work. So, try not to issue unresolved for a long time that’s what becomes that block of resentment between people in narratively ends splitting up people. Resolution is a very important aspect in terms of couples.
Shaz :: Is there anything else important around couples therapy that you could sink-up from a clinical psychologist point of view that people need to consider what take into account.
Ingrid :: Not so much from a clinical psychology point of view but I do think that couples, even though they are in quite a conflictual situation coming into couple therapy space. They do need to agree on whoever the practitioner is. It can’t be that one person is being forced into the space because the other one prefers this particular therapist. So, I would suggest that you find someone that both of you are comfortable with and you feel as though this is going to be a mediator who’s not going to favor 1 partner over the other then it becomes a neutral space and then we can work in a neutral space and I would suggest that you also find somebody who kind of like who is able to offer a safe secure environment but more importantly able to understand the dynamics within this relationship and all of the contributing factor.
Ingrid :: For example, I do quite a lot to work with an interracial relationship because of the different dynamics coming from different backgrounds, speaking different languages that’s just a recipe for huge amount of conflict. I’m not saying that interracial relationships are doomed to fail but they most certainly have quite a lot of challenges from the point of view that you grew up differently, have different goals and different family structures and now we were trying to blend these two ethnic backgrounds together it brings up its own challenges so being able to have somebody who is knowledgeable enough to be able to hold that space is important.
Shaz :: So more than anything it’s about putting in the research looking for someone who’s the couple feels would balance and match both of them so then I would say from the other side then there’s obviously going to be some sort of ethical guidelines around if you are treating one part of the couple in individual therapy then chances are that you would then have to refer out for the couple’s counselling because there might be a conflict there. Obviously as the counsellor or the psychologist you’ve got a more intimate relationship with one than the another, so they would need to find a non-biased therapist Okay. I can understand that there’s going to be all kinds of conflicts that come up in a relationship the most important thing is to find someone that you’re comfortable with who can mediate with an open mind it has enough knowledge around the different aspects that could affect a couple.
Shaz :: From that understanding I would then say like you said you see a lot of interracial couples so you would definitely be somebody that an interracial couple might see but there might be somebody else who specializes in may be transgender couples and the suggestion would be go and see because they’ll have more information and more understanding on it. So, although clinical psychologist can help with couples counselling and facilitated again you would need to put the research into see kind of what the psychologist themselves specialize in in order to make that informed decision.
Ingrid :: Everybody has a different area of interest, generally practitioners state their areas of interests. There are amazing therapists out there, who do look after transgender community for example and have done much more work with it. I would generally say that’s a good idea if you have a transgender couple and if it has something to do with sexuality or sexual orientation in particular then, I have to look at somebody who has a little bit more experience in terms of working in that field.
Shaz :: So if a patient wanted to or a couple wanted to reach out and book an appointment with your how would they get in to contact with you Ingrid?
Ingrid :: They can definitely book a session online on my website it is www.ingridnagaya.com and just go to the page that says book a session and you will have access to my diary.
Shaz :: Superb! I’ll add all that contact information at the end of the session. Is there any last thing that you would like to say around couples counselling from a clinical psychologist’s point of view?
Ingrid :: I think the one challenge we have as therapists or couple therapists is that people tend to wait too long and like I say the relationship on life support that you reach out, whereas some of these issues can actually be managed. If they manage sooner, they won’t become so complicated. I would definitely suggest to people that are in the longer-term relationships, meaningful relationships are always going to have challenges that’s what makes it meaningful. It’s an opportunity to be able to grow together. So rather than actually thinking that you are failing in a relationship, we should be more inclined to protect the intimate space in a relationship rather than worrying about failure and success. I do think that if we reach out sooner it makes it easier for people to resolve issues without necessarily getting individually hatch and distressed by the situation that just complicates everything.
Shaz :: All right, wonderful! That was absolutely wonderful to chat to you today and I’m really glad that we could get the information about what a couple would look for and especially that idea of that was preventative counselling, seek help or your online support my favourite thing I heard that they’ll talk about the straw that broke the camel’s back in a relationship and that my wife filed for divorce because of the lid on the toothpaste. No, the lid on the toothpaste was just the final straw don’t get it to the point where the lid on the toothpaste is the reason for your divorce. So, seek help early.
Shaz :: Wonderful, okay! Thank you so much for your time this afternoon and I look forward to chatting to you again in the future about any other topics that could come up around clinical psychology. Possibly looking at an episode down the line on depression anxiety and we would love to have you on board again.
Ingrid :: Amazing! Thank you so much Shaz.
Shaz :: Have a super afternoon Ingrid, Thank you!
Ingrid :: You too, take care. Bye!
Shaz :: Bye!
Hey everyone thanks for listening as always stay tuned and we’ll speak to you in the next episode.
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