We had a client recently who suffered serious complications during pregnancy. Her baby was delivered prematurely and for a while both mother and baby were at great risk. Later, suffering from post-natal depression, she preferred not to take anti-depressant medication. She went to see a counsellor who at her first session asked her to fill in a routine screening questionnaire which included questions concerned with risk. She was infuriated that the counsellor spent considerable proportion of the session focused on risk of suicide and she never returned for further treatment. Eventually she was referred to us for human givens therapy by her concerned midwife. This raises two important considerations.
Firstly, why is there still such stigma about getting help for post-natal (or indeed any other type of) depression? The answer must surely be because the causes of depression are still so misunderstood. Since depression is a form of “mental illness”, people tend to think that there must have been something wrong with them to have become ill in this way. Perhaps a genetic predisposition to mental illness, or some mental weakness or lack of coping ability?
The reality is that depression can affect absolutely anyone – and has much to do with the immediate environment and the day-to-day reality of our lives than anything about our personality, background, history or size and strength of our backbone. There is now a clear understanding of what causes depression and what can make it so hard to overcome. Even better, there are well tested techniques for helping people overcome depression quickly, effectively and permanently. We look forward to a time when the mechanisms which underly this debilitating illness become more widely known, when no one will blame themselves, or feel guilt about asking for effective help.
The depression suffered by our client was clearly precipitated by the traumatic pregnancy and birth.
The second point is the issue of compliance. In this situation, someone who was clearly struggling preferred the route of ‘no help’ rather than the help offered because she felt what was offered was inappropriate to her situation. She actually left the counsellor in a worse state than when she arrived.
Of course all therapists need to be aware of the dangers that clients may self-harm – suicide being perhaps the ultimate risk. But there are ways of doing this whilst keeping essential rapport with the client. We always assess risk and we also always ask our clients to rate each session before they leave. We find this provides vital feedback which we use to tailor our approach to meet the needs of each client. Whilst compliance is important, as stated in the recent Francis Report on the Mid Staffordshire Hospital, the needs of the patient must come first.
This particular client, when asked to rate “Is the therapists approach a good fit for me?” replied, “Yes, one million percent”. She reported feeling a lot better after her first session and is looking forward to her next and probably final session.