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.

E-mail Khopotso Bodibe