Dr Sabah Khan is a couple psychoanalytic psychotherapist who specialises in treating clients with neurological conditions, including Parkinson’s. We find out more.
How did you start working with couples?
I originally trained as a clinical psychologist, with a special interest in neurological disorders and neuropsychology. This is a branch of clinical psychology that specialises in the relationship between brain function and behaviour.
After some years of working in a hospital setting, I had a growing need to work with patients with their partners and family members. I felt that the impact of a condition was better understood through working together with people’s partners, rather than seeing patients on their own.
Now I combine neuropsychology with my main area of therapy, psychoanalytic psychotherapy. This style of therapy is based on the assumption that all people have unconscious thoughts, feelings and desires. Although not always known to us, these can still play an important part in how we experience ourselves and our relationships.
It involves working with clients at a deeper level, to understand the underlying causes of certain behaviours or issues and why these might be problematic for them and their relationships. The idea is to help them bring about a long-lasting change.
Sessions will often involve thinking about the changes that a Parkinson’s diagnosis may have for both partners. It’s important to understand the impact on intimacy, developing communication, and establishing how a couple would like their relationship to be.
What are some of the most common relationship issues you’ve seen in people with Parkinson's?
People with Parkinson’s can face the same problems in their relationships as couples without an underlying condition, although the context is often different.
For example, couples might struggle with communication, or sex and intimacy. But with Parkinson’s, there can also be difficulties in coming to terms with the diagnosis, and the grief and anxiety it can often involve, as couples begin to think about their relationship. There can also be changes in mood and levels of attention and energy, which can have an impact on the usual structure of a couple’s life. Medication can make some of these areas worse.
How can therapy help people with Parkinson’s and their partners?
Couples therapy can help both partners in a relationship adjust to the various changes that may come with living with a long-term neurological condition. It offers couples the space to begin to grieve these losses, to feel anger and frustration, and to gradually start considering and adjusting to a different life which still has meaning and purpose.
Sessions will often involve thinking about the changes that a Parkinson’s diagnosis may have for both partners. It’s important to understand the impact on intimacy, developing communication, and establishing how a couple would like their relationship to be. This might mean working on assumptions and expectations they may have about a relationship and each other’s role in it. The ultimate aim is to help strengthen a relationship so a couple can overcome difficult times.
Sharing feelings and maintaining closeness at times of distress and need are vital when faced with uncertainty.
How do you work with people with Parkinson’s and their partners?
I work with couples to help them realise that their life goals may have changed, but can still be achieved with some adjustments. Understanding the impact of the condition for both partners is essential. I draw on my specialist neuropsychology and health expertise to help both parties make sense of the cognitive, emotional and behavioural changes that have taken place.
Couples can gain an understanding of each other’s feelings and a sense of closeness. Sharing feelings and maintaining closeness at times of distress and need are vital when faced with uncertainty.
Therapy also helps to improve communication, so that both partners can feel better able to talk about difficult feelings which might usually be kept private. This might be because of feelings of guilt or not wanting to add to each other’s existing burdens. I also consider how a diagnosis can be seen as an opportunity for change that couples can creatively work out together.
What do you find is the most rewarding aspect of your job?
The most rewarding part of my job is helping a couple to develop their capacity to show gratitude, love and intimacy together. That might mean working through feelings of pain or suffering, anger and frustration, or loss and grief so they can reach a place of acceptance. Being part of that for me, is the essence of human connection.