Maryam

  • Family Therapy: Concepts, Process and Practice

    The book “Family Therapy: Concepts, Process and Practice” (Persian edition)

    Author: Dr Alan Carr

    Translators: Dr Bahman Bahmani and Nayyereh Ahmadi

    Subject: psychotherapy and counselling — family therapy, couples therapy

    Arjmand Publications

    Published: 2019

    About the book

    In this book you will find a critical appraisal of the major schools of family therapy, an integrative practice model for couples and family therapy, and examples of how to use the model with a range of common problems in children and adults. It also summarises research on the effectiveness of family therapy and how those findings apply in evidence-based practice, and the second part of the book presents the three-column model for formulating problems — and for formulating exceptions (times when the problem does not occur) — with clinical examples.

    “Rarely does one find a book in family therapy so innovative and different, reviewing the field’s core models and approaches, in theory and practice, so clearly and coherently. What sets this book apart, and makes it succeed, is that Professor Alan Carr does not merely review — he adds. With the formulation model he offers, he in fact brings together different perspectives from theory, science and practice into a method that gives the reader a ‘road map’ for therapy. This book is a valuable treasure that opens very fresh perspectives on therapy and on training therapists.”

    Professor Thomas L. Sexton
    Professor and Director of Family and Adolescent Studies
    Indiana University

    Translator’s preface

    When, about ten years ago, I first came across the English text of Alan Carr’s Family Therapy: Concepts, Process and Practice and used it as preparatory reading for teaching theories of family counselling and family therapy in clinical psychology and counselling departments, I never imagined I would translate it for students. But students’ enthusiasm for the chapters I gradually translated and gave them, depending on each course, soon led me to think of translating the whole book. One of my reasons for choosing it then was its rare — if not unique — comprehensiveness. Chapter one, for example, contains a very concise yet equally complete discussion of the family as a system and of the individual life cycle within the family, which no other text available at the time contained — and none does even now.

    Dr Bahman Bahmani

    Counsellor and psychotherapist

    Associate professor, University of Social Welfare and Rehabilitation Sciences

    To buy the book (Persian edition), visit:

    Buy the book

  • Emotionally focused couples therapy workshop

    Moeen Counselling Centre presents: a specialist workshop in emotionally focused couples therapy

    Taught by: Mr Amir Aghajani

    (family counsellor and couples therapist; PhD candidate in counselling, University of Social Welfare and Rehabilitation Sciences)

    This workshop is for counsellors and psychologists.

    Workshop topics:

    • The principles and foundations of emotionally focused couples therapy (EFT)
    • EFT’s theory of change
    • Step-by-step training in the EFT therapy process
    • Further topics, and solutions to problems that may arise in therapy

    Start date: Thursday 7 Azar 1398 (28 November 2019)

    20 hours in total (five 4-hour sessions), from 9 am to 1 pm.

    For more information and to register, please call the numbers below:

  • Introductory workshop on existential psychotherapy approaches

    An introductory workshop on existential psychotherapy approaches was held over 16 hours at Moeen Clinic on 17–18 Mordad 1398 (8–9 August 2019).

    In the workshop, Dr Bahmani gave a general introduction to the psychotherapy approaches that stem from the existential perspective. Topics included the shared foundations and core concepts of existential philosophy, and the main principles and definitions of psychotherapy theories drawn from the existential approach.

    Following on from it, in Aban 1398 (October–November 2019) a more specialised workshop introducing the cognitive–existential approach, one of the existential psychotherapy approaches, was to be held at Moeen Counselling Centre.

  • Children and the death of loved ones

    Death is an inseparable part of life — arguably the most certain event in anyone’s life after birth. Besides their own life experiences, every counsellor inevitably meets, in professional practice, people seeking help who are either worried about how those close to them will face the death of a loved one, or who feel unable to cope well with the aftermath of a loved one’s sudden or gradual death. Usually, much of what worries the first group is how the young children around them will react psychologically to a death. In the same way, schoolteachers and school pastoral staff, given how many children they work with, meet some pupils every year who have lost an important person in their lives through death. Meanwhile, it is probably the parents or carers of these children who feel the greatest strain at such times, and who most need to understand how children of different ages react psychologically to the death of someone close, and the right ways to respond to those reactions.

    The truth is that children react to the death of someone close very differently from adults, and within childhood their understanding of death also varies with age. Preschool children see death as temporary and reversible; up to about age 3, for example, the concept of death is beyond a child’s grasp. Between 3 and 5, children see death as a long journey and cannot understand that it is irreversible. At this age death is equated with sleep, and if children have not had enough chance to talk about death, or have been made very anxious by the way the adults around them handled it, they may develop problems with sleep and falling asleep. They may put the absence of an important person down to their own bad behaviour and hold themselves responsible, and so feel great guilt. Sometimes this guilt can leave serious problems with staying calm, sleeping, eating, and forming and keeping relationships with peers and adults.

    Between 5 and 8, a child’s understanding of death becomes more like an adult’s, but most children of this age still imagine it will never happen to them or to anyone they know. After 8 or 9, almost all children know that death is final and could happen to them at any moment. At this age, besides the anxiety of their loved one being gone, the child also develops anxiety about their own non-existence. They can also, to some degree, foresee the grief and anxiety of those close to them after their own possible death, and be affected by that too. After 12, alongside all this, anxiety about leaving things unfinished, about loved ones being left alone, and finally about the mystery of death’s journey can be seen clearly in the adolescent.

    How these anxieties show themselves, though, may differ fundamentally from adults. The death of someone close can bring great sorrow, despair and much anger. When a loved one passes away from a family, besides the emotional blow and confusion the child may feel directly, the distress of the other grieving adults and the emotional effects they experience can reduce how much they care for and support the child, which in turn adds to the child’s confusion and anxiety. Apparent indifference, or a mild emotional reaction, in some children — especially young ones — for a few weeks after a loved one’s death is not necessarily abnormal. It may be because they do not fully grasp that the person will not return, or cannot foresee the negative consequences. But where this indifference or denial of the death goes on, or grief reactions are delayed too long, it can cause much more serious problems later.

    At the burial, if a child is afraid to attend, they should not be forced. Clearly, involving them in the memorial service, the seventh-day and fortieth-day gatherings, setting the memorial table and so on helps restore their balance sooner. At such times the child should be given the chance to mourn and cry freely, to talk about their memories of the person who has died, and to express the love — or even resentment — they may feel towards them.

    A very important point: children under 12 are not advised to see the body of the deceased, and those around them should prevent it (especially if, for whatever reason, the body is no longer in its natural state).

    A child’s aggression (and even an adult’s) often comes from frustration in meeting basic needs. Since the person who has died met many of the child’s basic needs and their material and emotional security, the loss, as a major frustration, can produce a lot of aggression in the child. Clearly, if this aggression lasts too long or is very intense, the help of a child psychologist is essential. After a parent’s death, some children begin to behave more childishly than their actual age: more babyish behaviour, dependence at mealtimes, attempts to get the attention of those around them, a strong need to be held, and even baby talk can be seen clearly.

    When a child is very young, because of the egocentrism with which they understand the world, they attribute the cause of everything around them to themselves (until about age 7). At this stage they are quite likely to imagine that they themselves were the main cause of the person’s death. Clearly, the guilt from this thought can be very anxiety-provoking, and the anxiety shows itself in many behavioural signs. If it persists, it is a very major risk to mental health.

    Key points

    In the light of all this, when we are with a child who has lost an important person in their life, we should keep the following general points in mind:

    1. Children aged 3 to 5 imagine that the person who died has gone on a journey.

    2. Children aged 5 to 8 understand to some extent the idea of a journey with no return, but may show no signs of mourning at all.

    3. After age 8, the idea that death is final becomes settled in the child.

    4. After 12, children have a fairly complete idea of death, but their emotional reactions can differ from adults’: for example, they may say less, eat more easily, and even seem more active than before.

    5. What is common to almost all these stages is the anxiety of no longer seeing the loved one.

    6. Up to age 8, take care not to give the child messages suggesting the person who died has gone on a temporary trip, because it will leave them waiting for something that will never happen and delay their adjustment to the death. After 12, the child knows for themselves that there is no coming back.

    7. When the person who died is one of the child’s parents, anxiety about being unprotected and unsupported is clearly visible. So at any age it is essential to have someone who, despite their own grief, can answer the child’s needs for attachment and support. Because of the intensity of their own emotions, the surviving parent may not be the best person for this; be sensitive to it.

    8. Give the child the chance to express their positive and negative emotions freely, without shame, fear or denial. At such times it is essential to have an adult who, while showing their own sorrow, can listen calmly to the child, look at them, and support them directly or indirectly.

    9. It is strongly recommended that children are kept from seeing the body being washed or buried (especially under 12). It has repeatedly been observed that nightmares, mistaken beliefs about life and death, and fears of soil, sleep, darkness and basements develop in children afterwards.

    10. During memorial ceremonies, always give the child practical responsibilities suited to their abilities.

    11. If signs of sorrow, grief and mourning are delayed in the child for more than two weeks, be sure to see a child psychologist or child psychiatrist.

    12. What matters for the child to pass healthily through this time is that the people around them respond in the right way — which, sadly, despite the best of intentions, is often full of mistakes. So meeting the specialists mentioned above can help you help the child understand what has happened and adjust well.

    13. If the child is at school, contact the school directly. Discuss the situation with the head teacher, the pastoral lead, the counsellor and, above all, their class teacher.

    14. School staff can help most by giving the pupil enough time to readjust. At such times remember that a temporary dip in grades and poor schoolwork is nothing strange. Giving the pupil a chance to talk about their memories of the person who died, and the sympathy of friends and teachers, are very encouraging.

    15. While showing the child their own sorrow, giving them room to talk, and supporting them in expressing their worries, sadness and negative emotions, teachers should take care not to make too much of it. Sometimes a pupil who has not felt at the centre of others’ attention before may be inclined to express exaggerated feelings, and keep them up, to draw attention.

    16. And finally, let us remember that we cannot live through the experience for the child; we can only stand beside them and make their passage through the tragedy easier. This, of course, takes trust in God and time — so let us not lose patience.

    Dr Bahman Bahmani, PhD in counselling, associate professor and faculty member, University of Social Welfare and Rehabilitation Sciences

    Institute for Humanities and Cultural Studies

    Comprehensive Portal of Humanities

  • Applying psychotherapy theories in psycho-oncology (report)

    The Psycho-oncology Group of the Ala Cancer Prevention and Control Centre (MACSA),

    together with the International Institute for Research and Education (France)

    and Moeen Counselling Centre, held:

    A workshop on applying psychotherapy theories in psycho-oncology

    📆 Dates: 3 and 4 Aban 1397 (25 and 26 October 2018)

    On 3 and 4 Aban 1397, the workshop was held under the direction of Dr Bahman Bahmani, associate professor at the University of Social Welfare and Rehabilitation Sciences, with the collaboration of Dr Nowruzali and Dr Hojjat.

    Because of high demand, the workshop was to be held again two weeks later. For how to register, see: Workshop on applying psychotherapy theories in psycho-oncology

    What is psycho-oncology?

    Psycho-oncology is an interdisciplinary field concerned with the psychological consequences of cancer. It deals with the psychological effects of having cancer and with treating everyone affected by it — patients, carers and those treating them. Its aim is to help people with cancer and their families cope better with the psychological consequences of the illness, go through it with fewer psychological and social difficulties, and accept the hardships of this period more easily.

    Main topics:

    • Cancer: an overview
    • Psychological aspects of having cancer
    • Applying cognitive–existential theory in psycho-oncology
    • Applying Adler’s theory in psycho-oncology
    • Applying reality therapy in psycho-oncology
    • Applying Gestalt theory in psycho-oncology
  • Three years of learning to speak the same language

    The importance of the family system, and how the first years of married life shape how spouses come to know each other, were the subject of an interview by the Tebyan Cultural Institute with Dr Bahmani, counsellor and university teacher at the University of Social Welfare and Rehabilitation Sciences, under the title “Three years of learning to speak the same language”.

    The interview follows.

    Tebyan: Dr Bahmani, one of the problems young couples face is disagreement with their spouse’s family. How should these relationships be managed so that problems don’t arise?

    To answer, I need to start a little further back. First we should ask what marriage is. What does marriage lead to, and what is the function of what it produces — a function which, if not met, leaves it dysfunctional?

    Marriage is the starting point of what we later call married life, and married life is the ground for what we call the family. Families come in many kinds, but all of them were formed through marriage. We are born and grow up in a family, but before that, one day, a family was formed.

    The only accepted and effective way to form a new family is marriage — marriage that leads to the space of a relationship between two people, which is very beautiful, and which we call married life.

    Marriage is the starting point of what we later call married life, and married life is the ground for what we call the family.

    Other languages have no word as beautiful as the Persian zanāshuyi (married life), because it names the roles of wife and husband together, at once. It is a very beautiful word. In married life, wife is a role and husband is a role; before that, we were talking about a female and a male. The roles of womanhood — woman and wife — and of husbandhood — man and husband — mean the set of behaviours expected of this person in a particular situation. The role of wife and the role of husband together make married life, which builds the family.

    So what does the family do, that we stress it so much? The family works like a womb. What does a womb do? It turns a fertilised egg into a foetus and protects it until it is born, and if something goes wrong for the foetus it even helps to repair it. Once we are born from the womb we no longer need it, because a second womb is made to protect us. This second womb is made of the behaviour of two people whose job is to keep and protect us. In this second womb the baby is fed, cared for, and helped if problems arise.

    But it differs from the mother’s womb in that this time the man (father) and the woman (mother), together with the child, are part of the womb’s structure. Their behaviour creates a space in which they too are protected, nourished emotionally and physically, grow, and are supported if problems come their way.

    Marriage is a bond and a contract between two people who have at least a minimum of maturity: two people must come together. But I stress the words “two people”: it means that two people becoming one is a mistake. It is a psychological disorder for individuality and personal boundaries to disappear.

    Marriage builds a unit — but a unit of two

    Unfortunately, in marriage some people seek to become one with the other. A unit is built, but a unit of two. If you don’t understand what “person” means, you lose the meaning of marriage. In a good marriage both people are nourished and grow. The reason a good couple’s relationship lasts is that they meet each other’s needs. When needs are met, people become more mature; the more mature they become, the more unique they are; the more unique, the more alone; and the more alone, the greater their need for a companion to talk to.

    In a functioning marriage, because wife and husband each grow, they become two people. A healthy marriage is not one being erased in favour of the other, or one going unseen beside the other; it is both of them coming into view. The more you come into view and the clearer you become, the more differentiated you are and the more individuality you have. So in a functioning family, well-settled individualities are accepted. (That is at the individual level.)

    At the level of the family itself: there are two families, A and B. A son has come from family A and a daughter from family B, and together they form a new unit — and the walls of this newborn family are still fragile.

    A family must take in and give out information in order to regulate itself, and share information among its members so that they grow. This wall that gives and takes information is not hardware; it is software.

    What do you think a family’s walls are made of? What separates a family from others? I know families whose front door is shut, whose house number is clear and who have keys — yet everyone knows everything that goes on in the family, because they give their information to anyone. This family leaks; it is as if it lives in a glass house. Everyone sees inside and feels entitled to comment on it. This family has no walls, and everyone gets in.

    Some families, on the other hand, are like black holes in galaxies: no information comes out of them, and any information that goes in never comes back. They are isolated. Both are bad.

    A family must take in and give out information in order to regulate itself, and share information among its members so that they grow. This wall that gives and takes information is not hardware; it is software. Naturally, family members must exchange information in order to adjust to the neighbouring families. The secret of a family separating gradually, by regulating information, is a birth phase. When a person is born, the mother is in pain, and the baby also faces difficulties that can even harm it if not attended to.

    Great care must be taken that the baby is not born late. If birth is too long delayed it is dangerous and the baby dies, which is why, if it is not born naturally, a caesarean is done. A premature baby may even be born two months early and be kept alive with equipment, but lateness cannot run to a month: a few days too long can kill the baby, and even the mother.

    Children, too, must be born from their parents’ womb; they must form their own family. Like childbirth, this leaving brings psychological pain for the father and mother, because it feels like a loss, brings worry, and takes time to get used to. In this period they start doing things we call interfering. Parents generally both miss their child and, out of worry, start teaching. They give their child behavioural instructions for the new life that cause them problems.

    This leads the husband and wife into conflicts. They are busy making sense of their new situation and adjusting to each other, but someone from outside gives them different instructions on how to behave, and their adjustment is damaged. If the young couple don’t know how to regulate the information that reaches them and goes out from them, others will either have too much opportunity to interfere, or feel shut out and react.

    In successful couples, we call the first three years of married life three years of learning to speak the same language.

    This stage itself — wife and husband learning how to relate so that the parents are not upset and they do not lose their independence — takes time. Sometimes it takes two or three years, and a heavy price has to be paid for it. We must teach these people how to give their unit of two a wall — one that is not made of iron.

    How, and what, to pass on to each side, how to interpret incoming information, and how to share with each other: this is a skill that must be taught, so that the two learn to act, for the sake of their relationship’s identity, in a way that neither rejects the families nor dissolves them into them. It takes two or three years even with training — and without it, they never acquire it.

    In successful couples, we call the first three years of married life three years of learning to speak the same language. Unsuccessful couples never come to speak the same language; they only put up with each other.

    When choosing, young women and men are drawn to marry on the basis of similarities, and sadly no one teaches them otherwise; then after marriage, seeing the differences, the two think they made a mistake and ask for a separation. In fact, everyone marries on the basis of similarities first, and then has to manage the differences.

    This process of a new family being born from two old ones is painful and takes time, but it has its rewards, and if it goes well it brings joy and enthusiasm too. The result is a family with a new identity, which must also build its own private culture — a culture of its own, based on shared values; but thought must also be given to the values that differ. Time must be spent. Some things change in the wife and some in the husband, and some may stay different. If they are not among the fundamental values, that is fine — even good.

    Difference should not be a problem. Most of the time, as long as only the two of them are involved, they reach common ground sooner — provided their way is to exchange information. But if, on a particular matter, both families want to get involved too, finding common ground becomes a little harder.

    We must teach new couples to solve their day-to-day issues within their own family only. The first days are hard, because they are used to discussing everything with their own families. If it is about what to cook and so on, it causes no problem; but if it is about their way of life, it does.

    Young couples must learn, if parents take their child’s behaviour as impudence, how to apologise and tell them: you are still dear to us, we love you, but we cannot carry out some of your wishes.

    The two must understand that, when needed, they can get help from people outside the family, or from family members acting as advisers. Both must help each other to be born from their previous families. We must teach young women and men: come, be born, and build your own independent unit. Teach them it is hard and full of problems, but all of it must be done in good faith. Teach them that sometimes their parents will be upset — not because they were impudent, but because it went against what the parents expected. Teach them, if parents take their child’s behaviour as impudence, how to apologise and tell them: you are still dear to us, we love you, but we cannot carry out some of your wishes.

    Tebyan: Who do you mean by “someone else”?

    A wise person — a friend, a colleague, or someone around them who has a successful life of their own. They can ask them how they solved a problem like this. Of course, it matters a great deal that the person is wise and that we know about their life, that they live well themselves.

    Sometimes the two talk it through themselves. For example, the wife says: your mother behaves in a way I don’t like… The husband shouldn’t shout. They should talk, and then he tells his wife: I’ll help you so that the problem is solved, but don’t treat my mother in a way that upsets her.

    Then the husband might pass his wife’s wish on to his mother in his own words, because he understands his mother’s language better, and the mother then feels bound to respect it without taking it as an insult. Sometimes doing this takes several months.

    Tebyan: What should the first step be after marriage towards an independent family identity?

    The first challenge after marriage should be each person adjusting to their own family, and that requires a great deal of coordination between the spouses.

    We should teach our young people to act out scenarios — not to fool anyone, but to deepen the relationship.

    God says: worship Me, obey, and do good to your parents. It does not say “be just and obey”: justice might sometimes require me to answer my parents’ wrongdoing harshly, but the Qur’an does not approve of that. In every situation you must do good, but with the right behaviour you can manage them — because no father or mother wishes their child harm. If we act on this word, the problems in this area will be solved.

    Interview by the Iranian Family section of the Tebyan Cultural Institute with Dr Bahman Bahmani

    Summer 1390 (2011)

  • Exceptional children

    “People with special needs” refers to a wide range of human conditions in which people, for various reasons, have difficulties that create special needs for them. Exceptional children are one of these groups. Sadly, exceptional children are often poorly understood, and are sometimes even looked down upon. This article is about exceptional children or, more accurately, children with intellectual developmental delay.

    Some people think a diagnosis of intellectual developmental delay is right only when a person’s intelligence is below normal, and that most of these children cannot learn or look after themselves. In fact, diagnosing intellectual developmental delay requires two features together: first, a below-average IQ; and second, difficulties in coping with everyday life, to the point that the person cannot learn the basic, essential tasks of a fairly self-sufficient life. Even so, most children with a lower IQ can learn a great deal. As adults they can build fairly independent lives, and, more importantly, they too can enjoy life like anyone else.

    They too can enjoy life like anyone else.

    In the past, parents of an exceptional child were advised to place their child in an institution for exceptional children. That practice is now outdated. Today it is recommended that these children stay with their families, so that they can take part in social life too. The law also guarantees that the costs of their education and the services they need are met by the state from public funds.

    A child may also suffer from other physical and emotional difficulties at the same time. These children sometimes have problems with sight, hearing and speech that keep them from making good use even of the mental abilities they do have.

    A comprehensive, thorough assessment of these children’s physical and psychological abilities and disabilities is one of the most essential steps, and should always be done. Since no single specialist can assess and treat every dimension of a human being alone, it is essential to involve different specialists and draw on their cooperation. Medical and neurological tests and hearing, vision and physical tests are also very useful, and necessary, in helping these children.

    A low IQ does not mean all is lost. These people usually have positive qualities that specialists should identify and make the best of.

    Sadly, one common consequence of intellectual developmental delay — especially milder forms, in which the child is bright enough to compare themselves with those around them and their peers and to pick up on others’ remarks and hints — is emotional disturbance. These children often try to keep up with their peers, but because they learn slowly, or cannot learn everything others learn, they feel they have failed, and become anxious, withdrawn and discouraged from social contact. Since they are less able to put their sadness and worry into words, their depression soon turns into other behavioural reactions, and they show new behavioural problems, for example with eating and sleeping. Naturally, the earlier intellectual developmental delay is diagnosed, the more can be done to help.

    Ways of treatment:

    Contrary to popular belief, medication is not the most effective treatment for the effects of intellectual disability; rehabilitation, behaviour therapy, educational support and family counselling should always be used as well.

    So, in general:

    1. Intellectual developmental delay has degrees, ranging from mild to very severe.

    2. Intellectual developmental delay does not mean all is lost. These people usually have positive qualities that specialists should identify and make the best of.

    3. Genetic causes, illness, injury, cultural causes and a deprived learning environment are among the factors that cause intellectual developmental delay.

    4. Most people with intellectual developmental delay can learn the skills needed for a fairly independent life.

    5. Some people with intellectual developmental delay can complete their schooling under specialist supervision.

    6. Identifying other conditions that accompany intellectual developmental delay, such as problems with sight, hearing and speech, and treating or rehabilitating them, is essential to their mental health, and must be acted on.

    7. Most children with near-normal IQ (mild intellectual developmental delay) suffer from emotional difficulties that need treatment.

    8. Diagnosing and treating intellectual developmental delay and its effects requires many specialisms: psychology, education, rehabilitation and medicine.

    9. The mother should be the mainstay of help for these children. So in every case of a child with special needs it is essential to support the mother, train her well, give her an accessible counselling service for when she needs new information or to rethink behaviours, and encourage her to keep going.

    Dr Bahman Bahmani, PhD in counselling, associate professor and faculty member, University of Social Welfare and Rehabilitation Sciences. Adapted from the monthly Exceptional Education, issue 1

    Related reading:

    An introduction to rehabilitation counselling

    An introduction to child and adolescent counselling

  • Paediatric psycho-oncology workshop

    Moeen Counselling Centre presents: a specialist workshop in paediatric psycho-oncology

    Taught by: Dr Bahman Bahmani, PhD in counselling, associate professor and faculty member, University of Social Welfare and Rehabilitation Sciences.

    Applicants are interviewed before admission.
    ⏰ Length: 32 hours.

    Participants receive a certificate of attendance.

    📞 For more information, please contact Moeen Counselling Centre.

    ☎️ To hear about the centre’s other activities, classes and workshops, join the centre’s Telegram channel

    Paediatric psycho-oncology workshop: topics

    1. An introduction to cancer (what cancer is, types of childhood cancer, common medical treatments, side effects of medical treatment, genetic counselling in cancer, etc.)

    2. The crisis after a cancer diagnosis, and how to face it well

    3. Psychological aspects of childhood cancer for parents

    4. Psychological effects of childhood cancer on parents

    5. Psychological effects of childhood cancer on other family members

    6. Psychological consequences of medical treatment (medication, chemotherapy, radiotherapy, bone marrow transplant, changes in appearance)

    7. General aspects of lasting communication with the child (giving the child medical information, assessing their developmental and cognitive stage, the child’s needs, etc.)

    8. Family members’ communication with the child (parents, brothers and sisters)

    9. The child with cancer and school (the teacher’s relationship with the child, the effects of cancer on schooling and learning, etc.)

    10. Long-term effects of cancer and its treatments (follow-up after treatment, relapse, possible infertility, long-term side effects of treatment courses, etc.)

    11. Assessing the child’s development, including:

    • Motor development
    • Emotional development
    • Cognitive development
    • Biological development

    12. Taking a psychological history and assessing the child’s mental state, including:

    • Assessing possible psychological disorders before the cancer
    • Possible psychological disorders after the cancer

    13. Psychological interventions with the child: assessment and therapeutic uses of games, stories and activities, including:

    • Principles of building a therapeutic relationship with a child
    • Play therapy
    • Drama therapy
    • Storytelling
    • Role-play
    • Puppet play for emotional release
    • Drawing and expressing emotions
    • Free, healing conversations

    14. Psychological interventions with the child’s parents, using approaches suited to facing a crisis, getting through it, and growth after crisis and trauma, including:

    • Helping parents recognise and cope with their emotional reactions to their child’s reactions and questions, and to their child’s early death.
    • Helping parents face a crisis of meaning
    • Helping parents deal effectively with existential anxieties
    • Helping parents support their other children
    • Helping spouses rebuild their relationship after losing a child

    15. Psychological intervention with other groups around the child (nursery, school, hospital, etc.)

    16. Caring for a dying child:

    • Helping parents face the final stages of illness where it cannot be cured
    • Helping parents recognise the particular needs of children facing early death
    • Helping parents talk with the child and answer the child’s questions about death and what follows it
  • Family mental health workshop

    A “Family Mental Health training workshop” was held by the Basij Medical Community Centre of the University of Social Welfare and Rehabilitation Sciences, together with the university’s Student Counselling and Mental Health Centre, for a group of staff in the university’s Farabi Hall.

    According to MEFDA (University of Social Welfare and Rehabilitation Sciences), Dr Bahman Bahmani, who led the workshop, spoke about the importance of the family, its foundations and principles, and healthy communication in marriage. In his words: the family is an abstraction, a product of mental and emotional capacity; the family is the setting of birth, life and death.

    Referring to the books “Eight Lessons for a Happier Marriage” and “Marriage Without Failure” (Persian title), he described the marital relationship, which begins with a contract, as the family’s main pillar, from which the family’s other relationships take shape. If we make this relationship more capable, the family’s other functions grow too. In today’s families, after a while the children become the main concern — and this is not the best state of affairs, because the main concern should be the marital relationship.

    Dr Bahmani added: we don’t know how to take responsibility for our relationships, because we never learned — so what should we do now? We live in the present; when we live in the past, it means we are still the person we were. We grow in intelligence, cognition, understanding, knowledge and skill, but emotionally we have stayed in the past. In our past emotional relationships and the emotional ties we had — such as frustration, dependence and so on — that part of our being has stayed as it was. Nothing exists but what exists, yet we look for what is not; then what is also becomes what is not, and we go looking for a past that no longer exists.

    “The book ‘Marriage Without Failure’ explains seven ways husbands and wives try to gain communication skills that are very wrong, and explains present-focused, problem-solving ways for husbands and wives to talk with each other.”

    He stressed that one of the family’s missions is to help its members solve problems. Every member of the family should be trained, so that the family’s capacity to solve problems grows; the family is a problem-solving unit that helps its members solve their problems.

    “What is a problem? Any situation that can answer our need. Needs are innate and instinctive, and they are met through learning.”

    “Our wants and our needs are not the same. If our wants serve our needs, we grow healthily; but in many cases our wants do not help our needs, and even block them from being met. That is where problems and illness begin.”

    He went on: status and standing are an innate need. Respect is an innate need, whereas status is a false innate need; respect is a need, and so is the sense of being valued.

    “Everyone has the right to feel valued. Each spouse has the right to be accepted unconditionally by the other — but with the responsibility to answer the other’s rights. Their right is to have the other’s responsibility, and this is a rule.”

    “In human relationships we don’t look at ourselves; we don’t accept our responsibility for changing things; we accept complaints and criticism. This is a flaw, and it is the same in family relationships — a pervasive flaw that burns. In family relationships it is poison to want to fix the other person, to behave so that we don’t lose, and to imagine that if I leave this game I will lose many advantages.”

    Dr Bahmani also said: in religious teaching, you are charged with your own behaviour and answerable to God, and must not owe others their rights. But in being a couple there are two things, rights and responsibility. This responsibility really means: “I answer their rights so that I have rights, and can ask responsibility of them.” We should turn our minds towards discovering the other person’s needs and answering their needs and wishes.

    He added: we must gradually move towards turning the marital relationship into needs-based responses and wishes, because this is the right framework for a marriage.

    The workshop leader continued: motivation arises when a gap is perceived; motivation is whatever gives a relationship energy and direction.

    At the end of his talk he named “How to meet our own needs responsibly” and “Seeking our rightful needs without the slightest disrespect” as topics for the next workshop.

  • Cognitive–existential psychotherapy

    “Cognitive–existential psychotherapy” is an approach that integrates cognitive and existential theories.

    Helping people facing a serious threat of death, sensory–motor paralysis, human catastrophes, tragedies and natural disasters — or any situation in which a person’s core meanings are threatened or lost — calls for psychotherapy approaches that can effectively help them rebuild the meaning of their lives and adjust, effectively and realistically, to the consequences of such enormous losses.

    Being unable to rebuild meaning effectively can lead to severe, lasting depression and to a sharp decline, or complete collapse, in quality of life. The onset or worsening of psychosomatic illness, low morale and listlessness, generalised anxiety, phobias of many kinds, and a severe loss of motivation are among the consequences of being unable to rebuild threatened meanings.

    Cognitive–existential psychotherapy can be seen as a unique, integrated approach that draws on the benefits of “combining cognitive theory and existential theory” in understanding the pathology of anxiety and depressive disorders.

    The approach assumes that cognitive therapy techniques can not only correct dysfunctional schemas, negative automatic thoughts and cognitive errors, and so ease the psychological distress and injury of people struck by tragedy, but can also address existential concerns — such as dread of death, uncertainty, meaninglessness and loneliness — which other psychotherapy approaches have generally not answered well, and which lie behind much harmful anxiety.

    Dr Bahman Bahmani, PhD in counselling, associate professor and faculty member, University of Social Welfare and Rehabilitation Sciences

    Moeen Counselling Centre has run many workshops on cognitive–existential psychotherapy. To hear about upcoming workshops, please contact the centre.