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Couples counselling is the Key!


Cognitive Therapy for PMS and PMDD

Cognitive therapy has been shown to help people with depression and anxiety, so it should also help women who experience emotional indicators of PMS or PMDD, right?

Many females when faced with the time of the month when their nerves jangle and their mood can fly off the Richter scale turn to the medical practitioner for help or the local pharmacist.

It is true that the length of time that this trauma has its major impact is not great but when it is every month the compound effect can have a devasting effect on the whole of a woman’s personality. Especially when it is made light of by their partners and even comedians. To the sufferer, it is no joke!

There is two conditions Premenstrual syndrome (PMS) and Premenstrual dysphoric disorder (PMDD) whose symptoms cover the condition. It is estimated that 85% of women are affected by at least one Premenstrual Syndrome Symptom, and 3 percent to 8 percent of females experience PMDD, the more severe form of PMS. This adds up to millions of females thought to experience noticeable premenstrual symptoms.

Some medical clinicians are looking beyond the standard drug treatment and recommending seeking therapy with a mental health professional to help cope with the emotional symptoms.

The physical symptoms are bad enough but throw into the mix the emotional problems which can vary from woman to woman and one begins to understand how the feelings of depression; mood swings, anger, extreme sensitivity, the feeling of being unable to cope or mix socially can throw even the most level-headed of woman into an emotional wreck.

If the symptoms are so severe that they interfere with normal daily functioning such as going to work or unable to manage even the simplest of daily chores then it is more than likely to be classified as PMDD.

It is these symptoms that require more than over-the-counter measures and dietary changes. Many medical practitioners today are turning to Cognitive Behaviour Therapy with a professional counsellor to find the answer.

There is mounting evidence to prove that cognitive behaviour therapy is a beneficial way to ease premenstrual symptoms.

Cognitive Treatment is slowly being recognised as a useful tool in combating not only the immediate symptoms but also the cumulative effects of PMS and PMDD on the female. It has been used for years in the treatment of depression, anxiety and other health problems. All symptoms that are shared by PMS and PMDD. Researchers believe that cognitive therapy may help a woman understand how hormonal changes throughout the menstrual cycle affect their thinking and behaviour.

This is now being taken to the next stage when further research showed that when a partner joins the woman in counselling the benefits are compounded



Couple counselling can be critical for women in the treatment of severe premenstrual symptoms (PMS)
Leading female health researchers Professor Jane Ussher and Professor Janette Perz, from the Sydney University’s Translational Health Research Institute (THRI), compared the impacts of one-to-one and couples counselling for Premenstrual Disorders (PMDs).

The results, which have been published in the prestigious PLOS ONE journal, indicate that couple-based interventions have a greater positive impact on women’s ability to cope with premenstrual distress.

As part of a three-year Australian Research Council (ARC) funded study, 83 females who suffered from severe Premenstrual symptoms were randomly divided into three groups: a one-to-one therapy group, a couple’s treatment group, and a waiting list group.

The results revealed that couple-based interventions were the most effective in improving coping, reducing relationship difficulties and alleviating premenstrual distress.

84 percent of those in the couple’s remedy group reported increased partner awareness and understanding of Premenstrual Symptoms, compared with 39 percent of the one-to-one group and 19 percent of the wait list.

57 percent of females in the couple group reported an improved relationship with their partner, compared with 26 percent in the one-to-one group and 5 percent of the wait list.

There was an 18 percent reduction in reports of intimate relationship difficulties within the couple group, compared with a 5 percent increase in the one-to-one group to a 10% increase on the waiting list.

Increased self-care and coping were reported by 58 percent of women in the couple’s group, compared to 26 percent in the one-to-one group, and 9 percent of women on the wait list.

Professor Ussher says research consistently shows that relationship issues are deeply connected to females experiences of Premenstrual Symptoms.

“Issues within a relationship can trigger PMS symptoms, just as ‘that time of the month’ can seemly compound and worsen existing issues,” says Professor Ussher.

“It’s so common to hear that women are dissatisfied by elements of their relationship whether it is the emotional support that they receive at home or the dishes that are left in the sink at the end of the day.

“To use the metaphor of a pressure cooker for women who suffer from severe PMS, these issues can be left to simmer and for three weeks of every month, they are able to be repressed or ignored.

“But during that one week, when PMS takes hold, suddenly it all becomes too much. The pent-up anger and resentment finally reach boiling point and they are no longer in control leading to significant distress, and of course, relationship issues.”

As part of the research, the two remedy groups participated in five 90-minute therapy sessions over a five-month period with a female clinical psychologist, while the women on the waiting list received no immediate treatment.

Each PMDs therapy session was targeted to address the woman’s experiences of PMS, introduce a range of positive coping strategies, as well as to explore the role that their relationships played in their premenstrual distress.

Professor Ussher says, following the therapy sessions, women reported lowered premenstrual distress; increased coping; the resolution of relationship difficulties; greater couple communications; and greater closeness.

“Women reported that they were less likely to ‘lose control’ when expressing their feelings. They had increased awareness of the potential for relationship conflict; described relationship tension as less problematic; and were more likely to talk to their partner about PMS and ask for support,” she says.

These improvements were evident in both therapy groups, irrespective of whether or not their partner was involved indicating that any psychological intervention can have positive relational impacts.

“Even if women do therapy on their own, it can still have a positive impact. The women will still learn self-care and coping strategies, will develop a better understanding of PMS and will go home and tell their partner about the experiences in therapy,” says Professor Ussher.

“However the results of this study clearly indicate that the greatest positive impact is evidenced when a women’s significant other participated in the therapy sessions as well.”

Professor Ussher says the research further highlights the importance of providing women with access to psychological interventions for PMDs.



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