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Conditions that threaten women’s lives in childbirth & pregnancy

Counselling

Women we interviewed who had experienced life-threatening events in childbirth were sometimes offered counselling. This was offered through the hospital, GP or health visitor. Some sought counselling themselves. While some did not find it very helpful, many did. Some wanted counselling but were not offered any.
 

After having a life threatening condition in pregnancy, Paula had counselling provided at the...

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Age at interview: 49
Sex: Female
Age at diagnosis: 46
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So when did they start to emerge those symptoms? How long after it was it?
 
It was probably around the first six, seven months mark, yes, it was within the first year. 
 
And so did you pursue counselling?
 
Yes, I mean what I actually did was, I did go to the GP, the normal referral type route and they were fine and did a referral, but of course there’s always a waiting list, a waiting time, and in the mean time I’d been attending the local children’s centre. Because I was, you know, doing full time [daughter] care and luckily they had, like drop in counsellor... and I just thought, well while I’m waiting for my ‘proper appointment’ why don’t I go and see the drop in counsellor, because I just felt like that was the time that I needed to speak to somebody and I was potentially going to wait another four months or something for an appointment. In fact it was less than that, but they always say worst case scenario.
 
So in the mean time I went into see the drop in who funnily enough kept, she was like kept apologising because she was like a trainee counsellor, and this was kind of part her training and in the event was actually better than the real counsellor that I saw down the line [laughs]. Which I thought was highly amusing. But she was great. And because may be it was based at the Children’s Centre, it was based in that environment and she was obviously there to speak to you know, new mums and new partners about issues around having had a child and then I turned up with like this really extreme thing that’s happened [laughs].
 
And so it was incredibly useful, you know, and also because it’s fairly opened ended, because it was not oh your six weeks up and that’s it. She was just like, you know, as long as she was there and she was offering it, you know, as long as you can come come, kind of think. [Daughter] was young enough that she just used to fall asleep in the pram in the corner. It was quite sweet really [laughs]. So it was quite funny.
 
Women felt the need for counselling at different times after their emergency. Alison and Cara, who had both been in intensive care, were offered counselling while they were still in hospital.
 
There was great variation in when the women felt ready to talk about their experiences. While some women felt ready quite soon, others were not ready for a few months or even over a year.
 
Some talked early on, and then felt they needed to revisit their experiences again months or even years later. Being offered open ended counselling was therefore valued, as it was hard to know how long it was going to take to come to terms with their experiences.
 

Alison was offered counselling while still in hospital. She went for a few sessions when her son...

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Age at interview: 32
Sex: Female
Age at diagnosis: 30
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That was really helpful actually while I was still in hospital, the obstetrician offer… said to… I was going to ask actually about counselling, but she said to me, “Would you like to talk to somebody about it?” And I said straight away, “Yes.” Because I, I was really conscious that I wanted to try and, you know, obviously every Mum wants to be the best Mum they can be, but I didn’t feel, unless I got, got this out of my system and talked it through and dealt with it, head on, I didn’t feel that I was able to, able to be a proper Mum. I just I didn’t feel that I could be a good Mum whilst carrying this huge thing around with me, and I just felt that I need… that I would need to talk it through with somebody. And so, probably when he was about six weeks, I, I saw her three or four times. And actually that, short term that was, I didn’t really need to, I felt that then after that, I can cope with this, I’ve you know, dealt with a few things, and you know, I know the things that I need to do to help myself. And that was what I needed at the time. 
 
Then when it got towards his first birthday, I started to feel quite anxious and just really, I’d gone back to work when he was ten, ten and a half months old as well. So going back to work and leaving him for the first time, and everything else was quite. I did everything all at once I think, and I’d actually done some fund raising for the hospital as I went back to work and so I was in touch with one of the midwives at the hospital and I mentioned to her that I was starting to struggle leading up to his birthday and she put me back in touch with the same counsellor and I saw her a few more times, that’s how actually, and it’s strange, I thought I would have needed more support immediately after the event, but it was actually a year after that I felt that I needed more help. But I think that it just brought feelings out that I’d just bottled them up. I’d kind of packaged them away and said, that dealt with, and I hadn’t worked through my feelings, I’d just pushed them to one side and said, I don’t, that’s fine, that’s okay. Put a smiley face on and got on with it [laughs]. And it worked short term, but then it came back to bite me when I was least expecting it as well actually and so I struggled quite a lot around his birthday, which he really helped me to go back and think about what had happened and talk about, talk about the things, and really uncover the things that were bothering me. The things that I hadn’t even realised were issues really. She helped me to kind of talk those through and get to a spot where I could identify why I was feeling the way I was feeling, and, and also make me realise that there’s no shame in feeling upset about what happened. And that if other people have a problem with it, then that’s their problem. But, and so now, it’s good, because now I just say if I’m feeling a little bit down and someone will say, “Oh just think about what you’ve got.” And it’s amazing how many people say to you, “Oh but just look at the gorgeous son you’ve got.” As if, and then I would feel bad for thinking but that’s not enough, because he is enough. But it was almost as if, because I was still feeling bad, despite thinking of him, that he wasn’t enough to make… and I’ve now got to the point, where I say, “I’m feeling down about it, but that’s okay. I’m going to allow myself to feel down about it, or cry”. Because that’s what I need to do, to get it out of my system. And I find it just being like that and not suppressing how I’m feeling means it’s over and done with, so much quicker then, then if I squashed, squashed the feelings and they just hang around fo
 

It took Anna almost a year before she felt she needed to seek help after septicaemia (blood...

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Age at interview: 22
Sex: Female
Age at diagnosis: 21
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Before the anniversary, that’s when I really panicked, because I just thought, well what am I going to do. I don’t know what I’m… It’s weird, it’s like I was in, in prison in my head, and I was happy every, like I was myself still, I wasn’t , it was like I put on a front every day, and I don’t think many people saw past it, but my boyfriend did. And I know he worried for me, and he would just say to me, “You know, we need to get over this.” But not because he was like, oh get over it. It was because he could see how much underneath everything it was sort of eating me up and that was really hard. So when yes, when it came before Christmas I went, because I’d been going to the doctors and I had counselling and stuff like that, but they gave me counselling straight after. And straight afterwards, you are in shock and I think it takes up to six months really for you to sink it because it’s a forever change and forever is a word until you actually live it, if that makes sense. You know, you can say, oh you know, forever, but you don’t realise it until seven, eight months down the line that you actually think oh wait, this is, this is something I’m going to have to face. 
 
So I went to the doctors and I just said, “I, I need some help.” Told them, because I would think things and I’d feel bad for thinking them. And I’d think bad things, and I could never be honest with people about what I was thinking. So I went to the doctors and just said, “This is what I’m thinking.” I wasn’t going to kill myself or anything like that, but it was more like, I’d never ever think about killing myself, but it was more like the case of I just wish it would stop, I just wish for one minute this could just stop. And it wasn’t like killing myself, it was just the feeling inside me. I just wanted it to just stop. I just didn’t want to be here. I wanted to be here, but I didn’t, just didn’t want to be this person, this, this cage that I was in, and so I went to the doctors and I told them everything and they were just like, we need to get you to see somebody and then I ended up being put through to therapy quite quick and then obviously therapy has been going on and the stuff that I’ve, I ended up having to go through it all again and process it all and it really helped. I didn’t think it was, but she says as well that its, because I can like rationalise my thoughts, like I know when I’m having, but I’ve always been able to do it, I don’t know whether that’s everybody or whether it’s just me, but I can, if I think something I can make sense of it, and I think well that’s, that not really true you know. So I can step back from what I’m feeling and, you know, assess the situation.
 
And I mean I am on antidepressants. But that’s not me saying that I’m weak either because I’m not. I just needed, I just needed some help and there’s nothing wrong with that. I won’t let anybody make me feel like it either. Because most people, not many people at all have to go through what I’ve been through. So I won’t, I don’t like people, that anyone ever has, but I wouldn’t let anyone judge me about that anyway.
 
 

Paula asked for counselling when her daughter was about a year old. For her, it was about the...

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Age at interview: 49
Sex: Female
Age at diagnosis: 46
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Yes, so that was great. But I do wonder actually because it, it came just at the right time that I was able to go there and kind of unload stuff and I think I unloaded quite a bit of the kind of reserve anger that you kind of have there, about why should this have happened to me, you know, why couldn’t I have had a normal birth and all the rest of it if there is such thing. But you know, what I mean the aftermath was so kind of overwhelming really, that at the time you just work through it, and its only afterwards you kind of think, you know, you stamp your foot a bit and say that was really unfair, that happened to me. You know, and so I was able to do all of that with, with the counsellor then, just at the time I needed it. But I kind of think now, if I’d had to, if I hadn’t have seen her and I had to have waited for however many months it was, how much more severe my symptoms might have got, you know. So that, that concerns me actually that there wasn’t anything you know, more easily accessible, easily available. And although as I say the health visitor had been the one who suggested it way, way back when. I almost kind of think that its still, there’s quite a lot of hoops to jump through to get something. You know, as I say I was lucky that there was a different, there as an alternative route that I could go down and that may not have been on offer to a lot of people, you know, and … you know, it does, you know, make me wonder really.

Many found the counselling really helpful. Kerry had some counselling to help her manage her panic attacks after her haemorrhage. “I know she can’t stop the panic attacks. Only I can do that. But she’s shown me how to get through them.” Alison T had a similar experience.
 

Alison T was offered counselling from the hospital after her amniotic fluid embolism and...

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Age at interview: 44
Sex: Female
Age at diagnosis: 42
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So that the counselling service have been really, really helpful.
 
So tell me a little bit more about the counselling.
 
Yes.
 
When did you seek that or was that offered to you?
 
It was offered to me.
 
From the hospital or from your GP?
 
From the hospital. Which I think they do offer it to you if you’ve been in Intensive Care anyway. But, and you usually have to wait quite a while, but they got me seen quite quickly because of the history. And they started I think about six weeks afterwards. And I realised they were happening but didn’t understand why. And they were weekly sessions.
 
With an Intensive Care specialist do you think or …?
 
I just know it’s the counselling service for the hospital, so yes.
 
Okay and was that helpful?
 
Very, because they were able to tell me what to put in place when I could feel them coming on. And very helpful to know that what I was experiencing is quite normal for people that have been in my situation. Because you think you’re going mad, or you don’t understand why you’re feeling like you are. So yes, a very, very difficult time.
 
And how long did the counselling continue for?
 
It was only meant to be for six weeks, but I was offered it for ten, because I needed it. And I’ve had a top up session since as well. So I know if I feel myself getting worse I can phone up and they’re happy to see me. And just having that is a psychological help.
 
Just knowing that there is some help there?
 
Yes. Yes. Yes.
 
When did you have the follow up? What sort of distance?
 
I think it was a couple of months. I’d managed to go a couple of months without any …
 
Okay. So you haven’t had any counselling for a while now then?
 
No. Not for a while. I still do have the odd panic attack. But know how to deal with it.
 
What sort of things, what sort of things did they suggest you do?
 
It’s called CBT therapy. Which I found very helpful. And even things, just doing this with your fingers and with your toes can be helpful, because you’re focusing your mind on something else. I, for myself, I feel I need to just go for a little walk or something. I don’t like just sitting down, I have to be up, because it does frightened me. So you get the palpitations and sweats, and not very nice feeling.
 
And what is it about lying down do you think that’s…?
 
The counsellor just thinks it’s being in Intensive Care with all the tubes and going back to what I said earlier I could hear it, hear not everything, but I heard a lot. I was obviously a little bit conscious to be able to hear things. And its, it’s from then. It’s from when you hear that you can’t communicate. So that seems to be the stem of it.
 
And you mentioned PTSD, did they give you a diagnosis of that did they?
 
Yes, yes, they did. Yes.
 
And do you feel you have that still or do you feel that that’s…
 
In some situations. We’ve been to theatre since and it seems to be with crowds or I think it seems to be, the lady who was my counsellor summed it up compl
 

Karen had post-traumatic stress disorder after her emergency. 2 years on she was still having...

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Age at interview: 44
Sex: Female
Age at diagnosis: 42
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Have you been offered any other sort of counselling or support?
 
Yes. Through my doctor, through ICU talking to my GP and you know, the post traumatic stress that I had, I’m now seeing a psychologist through BUPA. Because what’s happened I’ve found that through this experience it’s brought other stuff to the surface that I’ve kind of not dealt with in the past. It’s been quite cathartic in a bizarre sort of way. Its changed me a lot in that I now, whereas I used to be, I wouldn’t say an easy going person, I’d say a person who is, who was willing to absorb things more and let things wash over me a little bit more whereas now, if somebody says something to me that I find offensive or hurtful or somebody does something. I’m, I just deal with it there and then. It’s almost like life’s too short to deal with rubbish and that’s the kind of effect it had on me, but it’s also brought a lot of other stuff to the surface as well. I mean I won’t lie and say the whole experience has been testing on our, my husband and I relationship… and so it’s just been helpful to talk to somebody as and when I’ve needed to, the psychologist so. Initially it was to see him about the post traumatic stress to do with having Byron but now it’s also dealing with all the other stuff that it’s kind of brought to the surface as well. So it’s been really, really quite useful.

And how regularly do you see him?
 
I was seeing him once a week. I’m probably now seeing him once every three weeks. Actually on a need to see basis, you know, I tend to sort of contact him if stuff comes up. And then I make an appointment and go and see him. He’s very, very good.
 
Was the post traumatic stress, how’s, how’s that helped you work through that? I’m just thinking because lots of people don’t get to see people and I just wondered if you could describe how, how that counselling helps?
 
Sure. It helps to talk to somebody who’s impartial. Because again, when you, when you have something like this happen to you, people deal with it in different ways and I think some people deal with it, by burying with it, that’s just their way of dealing with it. Some people want to talk about it. That’s me. But you’re very, well I’ve been very conscious that when I start talking, especially two years on. If I start talking to people about it, I just get this feeling sometimes when you’re looking at them that they’re thinking of for God’s sake she’s still going on about that. And I’m just very sensitive to that. Even though I know that other women who’ve been through the same experience, you know, five years on they still talk about it, they still relive it and it still affects them. It can’t be buried. But to be able to talk to somebody who’s impartial, to be able to get it off your chest and have a rant and a scream and a swear and what have you, without somebody judging you, is hugely important, really, really important. I would really strongly urge any woman who’s gone through what I’ve been through to go and talk to a counsellor or psychotherapist, especially if they’ve got access BUPA. There’s some really good therapists out there, you know, because if you could forget about this, you know, scenario and what’s happened you would, you know, you would, but you can’t. It’s just your way of dealing with it. The mind’s way of dealing with it.
 
Alison, who saw the counsellor again when her son had his first birthday, agreed that it was useful to talk someone impartial. She didn’t want to burden her family with her thoughts, because she felt they had been through enough already. “I didn’t want them to have to worry about me again because as much as I was feeling upset and a little bit down, I knew I was going to be OK.”
 
Anna and Paula both started counselling around a year after their emergency.
 

About a year after her septicaemia and hysterectomy, Anna started counselling. She explained how...

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Age at interview: 22
Sex: Female
Age at diagnosis: 21
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She explained to me about how the brain works. If you asked me to do it, I don’t think I’d be able to, but it’s basically just like how the front of your brain keeps the bad memories and that’s the one that keeps playing over and it’s trying to process it into the back part which is the memory. Like it’s really… I can’t, when she explains it to you, its yes, oh okay. But I’m not. I don’t know about it because I understand but the memories play over and over because they’re not being processed, they’re not being stored into like the library. So they play over and over and over again, and what you really need to do is just keep going over the situation with somebody, talking it through, talking how you feel, talking about it, because every time you talk about it, and every time you do something, you know, it helps it process it. Because when you’re thinking about it, you’re not processing it, because you’re just going round and round and round thinking about all sorts of different stuff. When you talk about it just processes it, like today me talking about it today will help me again, because I’m processing it. It will just go back into the bad memory folder and it doesn’t hurt when I’m talking about it. Of course it hurts but doesn’t bring back those nightmarish feelings and the trapped feeling. It’s just like I say a bad thing that happened. 
 
So the therapy sort of helped me there. And I’m still undergoing it, because I’ve obviously got. I still have issues and I don’t think that’ll change over the night. The acceptance of not having a little girl is hard. Now I wouldn’t lie to about that because it is. But it doesn’t rule my life. I’m at the stage where I’m grateful for everything I’ve got. I’m content with everything I’ve got. I don’t, although I wanted a little girl, and well you know, I wanted more children I’ve accepted it and its not, it’s just not as hard as it was. It’s just helped me. I mean I have to say. Well more recently I haven’t had it, because I ended up back in hospital for another reason, but yes, she was really understanding and I wasn’t judged and that was refreshing to be able to just say, “This is how I feel.” And I do not feel like I’m going crazy, to be told, “yes, that’s normal”, you know, “you are allowed to feel like that”, and to be told that, when you’re, when you’re in your own mind and you’re thinking things, and even you think “why am I thinking like this?” You can’t make any sense of it yourself. And then you tell somebody and then you go, “Does that make sense?” And they go, “Yes. Yes, it does and its normal, you know, you’re allowed to feel like that and it just makes you think, oh I’m not crazy, I’m not, I’m normal, you know, it’s a normal reaction and I think it makes you feel better for somebody to say, you know, because there’s no rulebooks, and it’s so hard. It, you do, you can definitely get through it.
 
But what is it that you’re finding hard, hardest to process? Is it not being able to have another child?
 
Hm.
 
Or is it the actual experience, the kind of near death experience?
 
Not being able to have children now.
 
Now?
 
And do you have any sense of how much longer you’re going to have therapy or is that …?
 
It’s a bit sort of ongoing. I mean she’s it’s just the acceptance no
 

The counselling that Paula finally started about a year after her amniotic fluid embolism really...

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Age at interview: 49
Sex: Female
Age at diagnosis: 46
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And did that counselling help? I mean did it help tackle those symptoms and the anxiety?
 
Yes, certainly the, the first counsellor I saw, I think it tackled more really because I think it did have an effect over the actual PTSD type things, they definitely diminished, but I think it actually made me realise that you know, I hadn’t been talking to anybody about it at all, you know, apart from obviously briefly to the, to the few people who were actually immediately involved in it. I tended to… not really go over stuff because it almost seemed so enormous, you know, that you don’t want to, to start to talk about how big it was to people who, particularly people that you know, you know, who are part of it as well. And so I do feel that there was other stuff. You know, there was other stuff I was able to deal with through the counselling that I wasn’t even aware really that I had been kind of back, you know, putting on the back shelf really. And I think that’s the thing that you know, I’m glad I did that at that time, and had I left it, I think it would have been potentially more damaging in the long run to have just not, not unburdened some of that stuff, you know. So it was, you know, it was the PTSD that was bothering me initially, but actually I got other stuff out of it, other than just dealing with those kind of symptoms. Because I do, you know, I mean there’s a fact that the whole thing about birth is strange until you’ve done it the once anyway. The whole thing is slightly nightmarish and unreal and all the rest of it, and then on top of that you’ve got you know, a set of circumstances that are really testing you in terms of the issues that you have to deal with. So I think that certainly, there certainly needs to be a stronger recognition of how, I think those things, as I say you do put them on the back burner, because your priority is to get on with looking after your child, and that is why you, you know, you wanted to have a child in the first place is to do those things. But in the meantime there’s all this bubbling away that you’ve just had to leave sitting there, you know, so I do think that you know, it’s important that there may be something more proactive really in recognising that those, those things are really better dealt with nearer the time than left you know. 
 
So do you think you would have liked counselling sooner than the six months?
 
Yes, I think so. Yes. I mean I do think now that, because in reality she was, she was more like one actually when I actually started.
 
Okay.
 
And I think that, I think even if it wasn’t something that wasn’t as much as formal as counselling something more like having, just having, I don’t know it sounds silly, to have the opportunity to go along and moan a bit, kind of… Because all the normal groups that are open to new parents, they just weren’t the right forums for me to start… I mean I did go to NCT stuff. I was a NCT member, but you know people were talking about things that had happened and you know the usual sharing and all the rest of it, and I felt like I could say nothing, because it was so ridiculous what had happened to me. Well I would have silenced the group if I had even mentioned any of it. So the kind of things that they were mentioning that were bothering them, I was just thinking, try dying in childbirth, you know, I felt like I was so out of, out of kilter with their experiences. So the things that were bothering me were so extreme that there wasn’t a forum for me to discuss it. 
 
So I think that, I think that it’s more that really. It’s more the peculiarity of it. And
There were different kinds of therapy on offer, but one method that several mentioned as helpful was cognitive behavioural therapy (CBT). CBT is a talking therapy that can help you manage problems by changing the way you think and behave. Alice found the CBT helpful in getting her to focus her mind on something else. Belinda was offered CBT as well as medication after she developed postnatal depression.
 
Some women said they did not need any counselling, as they had enough support from their families and friends. Others who had not had counselling said they wished it had been offered. It would have been a good idea to help them make sense of what they had been through. Sophie and Tom were offered counselling but turned it down, but with hindsight they think this might have been the wrong decision.
 

Although she was offered counselling, Kate did not feel she needed it after she developed HELLP...

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Age at interview: 35
Sex: Female
Age at diagnosis: 34
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Has anyone spoken to you about counselling, or do you have counselling?
 
The doctor did say that she’d put me in contact with a counsellor if I wanted, but this was partly the counselling, writing the email was certainly a weight off my mind. Talking to friends, and I think I’m over that now. I don’t need the counselling. Yes, just getting on with things day to day routine helps. But I’m lucky that I have a supportive family and lovely friends. Because if I didn’t then it would be very hard I think.
 
 
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Samantha had pre-eclampsia and her daughter was delivered early and in neo-natal intensive care...

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Age at interview: 32
Sex: Female
Age at diagnosis: 31
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I think in hindsight I wish that I’d gone back to talk to someone about what had happened. Not necessarily the issues of our daughter being in special care, but what happened to me. And I think it would have been good if there’d been some sort of group that I could have gone to of other mothers that had been through something similar. There seems to be lots of help for sort of parents who have got children who are poorly. But there doesn’t seem to be that much discussion about if you’ve been through a difficult birth experience, and whilst I had my NCT post natal group that I spoke with, that was just one, one week out of sort of eight, and then we sort of went on and we were talking about parenting stuff and things like that. And I think yes, in hindsight I would have liked to have been able to talk more about what had happened. Not necessarily to get any real resolution on it, because I understood exactly what had happened, but just to talk about it. And to know that there were other people out there who’d been through difficult experiences.

 

Sophie and Tom reflected that although they said no when it had been offered, what they both...

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Age at interview: 38
Sex: Female
Age at diagnosis: 36
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Tom' Had they pointed me in the direction of counselling at that time I wouldn’t have taken it.
 
Sophie' Yes.
 
Tom' I would have gone, “You must be joking aren’t you?
 
Sophie' Yes. Well it’s difficult to know isn’t it? I remember when they said to me, “Would you like counselling.” And I thought no, no, I think, I think I’m clear on what’s happened and you know, and, and the risks and all that. I think I’m clear on that. And, but also you think well when are we going to have time to go for counselling, I can’t even get time to come and go to my appointments. I’ve got no support.
 
Tom' Hm.
 
Sophie' So if I’ve got no support I can’t really come to sort of the counselling anyway. So no, no, I don’t need counselling [laughs]. You know, there is that, that element to it.
 
Tom' But yes in retrospect that was what was needed.
 
Sophie' Yes, perhaps for both of us may be.
 
Tom' I had it in my mind that I’d got to keep slamming away at the coalface to solve every time a problem was arising. And that simply wasn’t the case, you know, what we needed to do was sit back, have a bit of time together and then just you know…
 
Sophie' Collect our thoughts.
 
So yes, because you don’t really know what, what counselling can do, unless you actually to it do you? I mean people will say, “Do you want counselling?” Well I don’t know, what will it do for me? You know, will it help. No, because you sort of think well no because you know, I’ve already been through this. It’s not going to erase it, so what’s it going to do. But you know, may be it could of, I don’t know.
 
Tom' You’re incredibly strong and able and you know, you haven’t had the issues I had with it all of sudden it catches up with me at certain point, and you know, perhaps more importantly, you had to deal with that. You had to deal with me, not being very helpful from time to time. And… you know, deal with it effortlessly. But I mean… that’s sort of what I’m getting at, you were ultimately far more capable to deal with it then I was.
 
Sophie' I think I was just so relieved to be here [laughs]. I think that’s the attitude I took. It’s just like what. I’m not really complaining about this because I’m still here you know, and these people are a team of professionals that have helped me to still be here and I’m very grateful for that.
 

And you know, I’m going back to work and starting to put things behind me a little bit and moving on, and it was actually really good, and its actually been, you know, recently it’s been kind of in the mist a little bit really. 



Last reviewed April 2016.
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