should I force him to continue counselling? advice sought

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DH has had some anxiety/OCD issues in the recent past triggered by the birth of our DD which have sometimes led to bouts of aggression (verbal, not physical). He gets ludicrously worried about her safety, to the point where he can be controlling and critical of me and a pain in the arse to live with. He has recently become much more aware that he has a problem and has been to the GP about it and the GP referred him to a counsellor. At the same time he was put on some antidepressants which he's been taking for about a month.
The antidepressants have worked incredibly well... he's much calmer, much more able to see flashpoints coming, more able to avoid them etc and generally is doing much better, we're arguing far less and he's just nicer to be around.
He's not really getting on so well with the counselling though, just doesn't think its his thing at all and wants to stop (he's had three sessions).
A lot of his problems are rooted in his childhood: his dad left his mum at a very early age, he was parcelled around to live with relatives because his mum couldn't afford to look after him (he comes from a third-world country). I believe quite strongly that he won't ever really overcome his issues without therapy. But he's adamant that the ads are all he needs, along with various other stress management techniques.
Bottom line: what can I do. I'm worried that if he sacks off the counselling it will be much harder to get more down the line and that he will regret it. I'm not opposed to antidepressants on principle and I know they help some people a lot but I also think he should seek strategies other than chemical ones to deal with this. Should I issue some sort of ultimatum to him to force him to do it? Or should I just accept that he's not digging it and be grateful that he has found something that works for him?

I think you do need an ultimatum. Agression is completely unacceptable and not something you can tolerate, especially if you have a child to consider. If he's saying he doesn't want to deal with that aggression in its entirety then that his his decision. But my view would be that he forfeits the right to be part of the family if that's the path he takes. No half-measures.

Cogito I get that, and he says he gets it too. His argument is that the pills work for him, therapy doesn't. I'm skeptical of this, although based on his behaviour over the past few weeks, the pills are helping a lot. I've got a total zero tolerance policy towards verbal aggression now -- its happened only once, quite mildly, in the past month and I slept in the living room. I told him I won't tolerate it and he accepted that he had overstepped the line and so forth. I know I have the right to exclude him from the family if he exhibits aggression and to make him deal with it as a condition of remaining in the home, but do I have the right to force him to go down one particular route as opposed to another?

I think it's fair to give him a chance with the ADs rather than insisting he continues with the counsellign if he isn't finding it helpful. Counselling is not magic, it doesn't work for everyone, and some counsellors are arseholes, as well. You want to make sure your H's behaviour is acceptable, and that's fine and reasonable. How he ensures that his behaviour is acceptable is up to him.

You can take a camel to an oasis but you can'tmake it drink.

He knows he has a problem. You've been understanding that he has all these childhood issues. That is no excuse of being a verbally abusive person. He cancontrol this as I'm sure he doesn't that at work or with other people he associates with. He choses to be verbally aggressive whatever the reason for it.

I went for counselling once, it was a waste of time. Some people just dont find it helpful. If he hates it you can't force him. If you force him he will probably do it half heartedly, to silence you.

The ultimate question is, since you realise "he won'treally overcome his issues..." are you prepared to take him on and live with this appalling behaviour and accept that he is an abusive twunt or do you think you deserve someone nice/empathetic and mature? He can't take out his childhood issues on you and reduce you to the level of his depression. AD are just a temporary fix and you both know that. As life brings on more challenges as can happen, he might get worse and become a total killjoy for you.

It all boils down to whether you accept him like this or not.

If he doesn't want to go I don't think it would work. He should discuss this with the counsellor though. They may have a colleague whose approach is better suited or might be able to sort out why it's not helping. You could also ask them to arrange a review appt in 6 months to see if things are still better. I don't think a gp could dispute a re- referral I the future if he is clear he is stopping as he feels better now. If he just stops turning up the team may be reluctant to offer more appointments later on.

dryjuice Point taken. I'm not trying to make excuses, but the verbal aggression is occasional and always regretted. I know it should be an absolute no-no in a marriage, though, and I'd be lying if I said I hadn't considered ending the marriage over it.
But when I said that thing about not being able to overcome his issues, what I meant is his self-esteem/OCD/anxiety issues, not the verbal aggression. Apart from one minor incident recently there's been no verbal aggression since before Xmas and I do think he has this generally under control for now. What concerns me is that he has deeper-rooted issues and he's passing up a chance to deal with them.05

Op. Self esteem/OCD and anxiety are very common issues and lots of people struggled with them but don't necessarily need counselling. The are books out there that can help esp with self esteem/anxiety, if he likes to read. Hopefully someone will come along and recommend one/two as I have no idea which ones might help him

It's good that he realises you will not accept verbal abuse and is getting better at managing his verbal diarrhoea outbursts, which was the problem really and is showing a bit of respect for you. He probably had the male version of post natal depression and given his "issues", the birth activated something overly protective in him and did'n't handle this problem very well.

Good luck with this.

At the moment, the ADs have helped reduce a lot of his problems and he is naturally satisfied with this. So he thinks that nothing else is needed and taking the Ads for longer will iron out all the kinks. Wrong. He is in a 'cruise' phase of treatment for his Mh issues; it's all so much better that he can't see that there is still so much going on underneath that he will always be at risk for his abusive behaviour.

It's a bit like getting a constant sore due to blood poisoning. He's currently dressing the sore, so feels it is all taken care of. But the blood poisoning remains, that has to have treatment or he will always risk future flare-ups and will never be free of needing to dress the sore. Does that make sense?

There is of course, the fact that he just might not gel with his current counsellor, but might do with another. Could trying another one be an option?

Posting this as an OCD sufferer, whose condition also worsened after having a child.

When you say that your DH is having counselling, do you actually mean counselling or CBT with a psychotherapist?

It makes a big difference - I had counselling when I was pregnant with DD and it was about as useful as an ashtray on a motorbike. OCD is generally characterised by the sufferer thinking too much, which is why many talking therapies are not recommended in the treatment of OCD

The treatment recommended in the NICE Guidelines for OCD is CBT (Cognitive Behavioural Therapy). This is most effective when combined with the right medication. I'm sure I've seen it said before that the NICE guidelines can be taken to show your GP if they are not supportive of this.

It is important to get a CBT therapist with experience of dealing with OCD, as the treatment of OCD is very specific, involving ERP Therapy (exposure and response prevention therapy) - which is very scary, but ultimately the most effective therapy for OCD sufferers, where the sufferer has to do practical exposure "experiments" where they face their fears and ride out their anxiety.

I recommend ocd action. There's also an organisation called OCD UK. Both of these organisations offer information and support for both sufferers and the loved ones of sufferers. Pretty sure you can get a link to the NICE guidelines from at least one of these websites.

Also, a useful book is Overcoming Obsessive Compulsive Disorder by David Veale and Rob Willson

I'm a lot better than I was (due to a combination of meds and therapy), but when my OCD has been really bad, I have been totally blinded by terror, struggling to get out of bed in the morning, and seeing everything around me as things that will cause deadly peril to my child, so it's not an easy condition to face up to. Your DH will need to make the commitment to himself and your family and be willing to put himself through some pretty scary stuff - but it is worth doing.

My marriage has not done well through my illness, so I urge you to seek support for yourself as well as DH so you can both gain an understanding of what OCD is about and how best to deal with it.

Good luck :)

Something else I'll mention is that "avoidance" is a strategy that many OCD sufferers use for "dealing" with their condition. It has the same function as a compulsion - i.e. you do the compulsive action to momentarily "deal" with the upsetting thought. In the same way, you avoid your fears to momentarily "deal" with the upsetting thought. It is not a good strategy. Your DH will be feeling much better with the meds if they are the right ones for him, but alone they will not help him tackle the illness in the way it has to be tackled - which unfortunately means having to deal with the upsetting thoughts. Hope that makes sense?