KHOPOTSO: Seeking counselling as a couple has often been frowned upon and regarded as a last resort as well as an admission that the relationship is failing. But the pressures of modern life, including the reality of HIV and AIDS, makes counselling a wise and useful process for couples. Gavin Robertson is a psychologist who works in the field of HIV couples’ counselling.
GAVIN ROBERTSON: What we try and do is reduce any blame that happens in a situation to an absolute minimum because as soon as one person in the relationship starts blaming the other that blame leads to a decrease of their own power because they no longer feel that they can do something about the situation’¦ Our whole focus is on what to do about the situation now because you don’t know where it came from and you don’t know when that person became infected ‘ in a previous relationship, or whatever the case is. We can’t work that out now. What we need to deal with is how best to work this relationship. So, we avoid any blame and deal with a focus on responsibility in the relationship.
KHOPOTSO: Disclosing one’s HIV positive status to a partner, especially one whose status you don’t know or are not certain of, can have implications. In that case, using the services of a trained couples’ counsellor in HIV might be helpful.
GAVIN ROBERTSON:In actual fact people use coming to the clinic as a way of disclosing because they feel much more supported to do that with a counsellor present. They feel that they will get emotional support, and sometimes even protection because sometimes they’re actually concerned that the partner will become aggressive with them, or violent if they tell them.
KHOPOTSO: Robertson says it’s not uncommon for HIV to elicit finger-pointing and violent outbursts.
GAVIN ROBERTSON: From a psychological point of view, often what happens is that instead of taking responsibility for a situation, or their part in a situation, they’ll take that negative part of themselves and want to rather push it out and project it on to somebody else, saying they’re at fault. In a sense they want to distance themselves or separate themselves or sometimes even be violent towards the other person as a means of trying to crash that negative aspect in the other person, which doesn’t work very well because actually what they’re doing is trying to project a negative aspect of themselves on to somebody else.
KHOPOTSO: He adds that the key to couples’ counselling is to help people own up to the reality of HIV in the relationship and to acknowledge their role in it.
GAVIN ROBERTSON: The whole focus in the counselling is on people being responsible for their own situation, their own feelings, their issues’¦ and then working together with the relationship. It’s not the other person’s fault. It’s the responsibility of both people in the relationship to make this relationship work and to protect each other.
KHOPOTSO: HIV infection casts doubt on the ideal of trust in relationships, as it can necessitate that partners continually seek to find out about their status, even when in a supposedly monogamous, long-standing relationship.
GAVIN ROBERTSON: Most of transmissions, especially now in Africa, are happening between couples and, particularly, in stable relationships because people are not aware sometimes that one partner is HIV positive; or they assume that because they are HIV positive that the partner is also HIV positive; or they assume that because they’re negative the partner is negative, or vice versa. So, discordancy ‘ having one person negative and one positive in a long-term stable relationship seems like a mystery to most people. And it is, because we don’t actually have an explanation for how this happens.
Couples’ counselling services are offered at the Tshwarisanang Centre at Chris Hani Baragwanath Hospital. Contact: (011) 989-9840.
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