Centurion, Gauteng, South Africa
Dr. E Tlou, a clinical psychologist, relationship counselor, sex therapist, and life coach, posts articles and information regarding a variety of psychological issues confronting people every day. In addition, he responds to questions about relationships, sexual difficulties, and other concerns that have been submitted through his website.


Thursday, February 3, 2011


The world today has a lot to thank technology for. You would not be reading this blog and I would probably be getting less work if it had not been for the internet and its corollaries. There is an odd thing that I have seen in my rooms for the third time a few weeks ago. When I saw it the first time, I did not blink as I thought it was an idiosyncrasy of the relationship I was working with at the time. The second time I saw it I smiled inside and thought “Interesting”! The third time I thought, “Hell, there’s got to be something behind this”. As I usually do in between sessions, I thought deeply about it afterwards and tried to conjure up a hypothesis to explain it.

Here is the thing I saw: A couple shows up and I do what I always do in my first encounters with couples. Listen. I listen to both versions of the relationship experience in order to get an understanding of what is going on. In these three cases I was dealing with couples who were not talking to each other at home. Listening to them, I could picture in my mind a home where there is no life, as we say in Setswana. The couple could be described as almost hating each other’s guts. They just cannot stand each other. What was interesting with those couples is that although they could not bring themselves to look each other in the eye and talk, the moment they got to the office they would turn their computers on, go on-line and start sending e-mails or SMSes, sometimes abusive in content, to each other. Do you get it? These are people whose description of their problem is “We don’t communicate”. By communicate, they mean talk. It is difficult for them to talk to each other verbally, yet they can talk electronically. Does this mean we have “dual” personalities – a real one and a virtual one?

My explanation for this kind of behaviour is that technology has created distance between people, while creating closeness between people and machines. Distance comes with safety – what is far from you cannot harm you, therefore, we have come to feel “safe” when we are in the virtual world where we cannot be “touched” (it works differently when you are in a studio ☺). Come to think of it, we worship machines. Look around you at teenagers (some adults too) today. They walk around with white wires hanging from their ears and looking down on a screen in their hands while their fingers are pushing buttons. You can get a heart attack and die next to them and they will not take notice. Even when they do talk to people around them they are still looking at gadgets and busy with their fingers. Communication by talking and listening is one of those skills that have been honed by the process of evolution to help our species survive. Survival requires that people collaborate and share, which makes communication essential. In the modern age, it seems, communication is done through electronic devices that obey their users’ instructions, thus making it easy for us to have our way and not negotiate. You press a button and the gadget responds. Eeeezy ne! (Remember that advertisement on TV those years?). In the pre-tech world people had no choice but to be in the same physical space and talk things out when they needed each other’s attention. Sitting, facing each other and talking was a natural human survival skill, whether it was in a cordial or hostile atmosphere. For this reason the human capacity to reason and relate became highly developed in people. I am sure a 15 year-old of 1911 had better conversational skill than a 15 year-old of 2011. It would also be interesting to compare a city teenager with her rural counterpart on conversational and listening skills.

The introduction of high-tech communication devices, while essential for survival in the modern world, have a downside that results in people needing psychologists and anti-depressants. The downside is that people lose touch with each other and what it means to be a human being. For this reason it does not come naturally to people in relationships to sit and talk things out when there are problems. It is much easier for them to reach for their computers and Google their problems (The good thing about Google is that they will find me and give me work ☺). Now on a serious note, I do not think this is a psychologically healthy thing to do. No problem of living gets resolved by searching the internet or bitching by SMS. People still need to talk. Talking is a natural problem-solving skill that evolution has hard-wired us for. That is why we have imagination where animals have instinct. Technology, instead, seems to be turning us into cowards who become brave in the virtual world but meek as lambs in the real world. What e-mail and SMS communicators need to realise is that written communication can, should the wheels come off and lawyers get involved, be used against them. So, cybervitriol is immature and self destructive if this is considered. You cannot, as government spin doctors like to say, be misquoted or quoted out of context when your e-mail or SMS is read out in court.

At this point I am reminded of the Eskom blackouts of two years back and how I am thankful for them because they have created a positive memory for my children. One Friday evening of heavy rains when the Eskom coals got soggy the lights went out. I was alone with my two boys, then 9 and 6 years. I had to prepare our dinner by charcoal and we had dinner by candle light. As there was no TV to watch, the boys asked me to tell them a story. After thinking for a minute I told them the fable of Tselane and the Giant and The Lion and the Hare that I recalled from primary school. They sat captivated and entranced. They enjoyed every bit of it. I enjoyed it too. Interestingly, it was on that night that I observed that the little one’s missing tooth was growing again. I am telling this story to illustrate how technology creates distance between us and that it does help if we do without it at times. As you can see, Eskom blackouts are not all that bad!

My recommendation to couples, especially those who find it easier to send each other e-mails and SMSes, is that they start making time for each other. I actually recommend dating. This is low budget dating which happens as follows: No need to go out and have dinner by candle light. Just make a date to come home early, sit down, face each other and TALK. Another hard recommendation I would make is that people start having a tech-free day every now and then. That is a day of no technology – no TV, no computer and no telephone. As a person who enjoys camping and bush holidays I can vouch for the rejuvenating benefits of taking leave from technology. Going out in the bush or having quiet moments at home is when you start being aware of your senses again and your soul takes a breather. That adds, in small ways, to your being human and in touch again. For as long as we allow technology to rule us, we will lose touch with ourselves and others. So, make time for tech-free, quiet moments and see how you feel afterwards. Believe me, it works.

Do you have any comments on this article?
© Dr Emmanuel Tlou
January 2011.

Tuesday, August 24, 2010


Increasingly I hear married individuals say things like: “I am in this marriage for the sake of the children”, or “I love him/her, let me give him/her a chance to change”.

What I want to discuss in this article is controversial and might get me burned at stake. Contrary to religious edicts that marriage is an institution from God, or cultural injunctions that a person (especially when referring to women) must “hang in there.. life is like that” (Kgotlella, ngwanaka), I want to say: If it doesn’t work, GET OUT!!!

Here is why...

All people get married with good intentions. We are hard- wired by evolution to seek intimate companions (same or opposite sex) to take care of our dependency needs. Dependency needs are essential for communal survival, which makes people maintain closeness. Closeness is one of the ingredients that are essential for the survival of our species. The closeness provided by marriage is good for the couple’s mental and physical health. The joy gained from a happy marriage is good for the healthy emotional development of children who, in most cases, would be parents and spouses when they are adults.

Things do go wrong in marriage, though. There are myriad reasons why, which I will not explore here. However, I want to talk about the emotional pains that an unhappy marriage can bring.

Marriage is ranked 7th on the list of 42 major stressors that are known to contribute to psychological ill health (This is from Social Readjustment Scale designed by Holmes and Rahe which you will find reference to in most books on stress). This is primarily because marriage is – as my clients often hear me say – “a work in progress”. It is never perfect. There are always problems that a married couple have to navigate and (re)negotiate. When one hurdle is overcome, another appears. Not everyone succeeds in dealing with the trials and tribulations that marriage brings. Sometimes, often after years of bitter fights, marriage has to end and the couple have to go separate ways. Paradoxically some people stay married long after the marriage has ended as evinced in the opening paragraph of this article.

I am one of the professionals who believe that marriage has to end when certain litmus tests have been failed repeatedly. Here are two of the litmus tests according to me:

LITMUS TEST 1: Do you experience emotional pain most of the time?

The cardinal rule here is if it hurts you, then it is not good for you. Marriage is supposed to make people feel fulfilled and happy to be with each other. If there is too much pain for too long it is no longer worthwhile. The danger about pain that most people miss is that pain can be addictive. By addictive I mean a person becomes numbed to their own pain. The pain starts feeling “normal” such that a person starts fearing how life would be in a painless relationship. This explains why some people leave one abusive relationship for another (see my article on Relationship Addiction below). For a person in this state, pain has become a sense of self and they cannot define themselves apart from their pain.

That is why, when I notice that a couple are hurting each other too much despite therapeutic interventions, I do not hesitate to recommend divorce. Although religious people (I am religious too) would cry SIN at the sound of that word, I do not think it is always a bad thing. Sometimes it is the best therapy, especially where children are involved. I have said to some couples in therapy who talk about staying for the sake of the children that children are emotionally better adjusted living with one parent than with two parents who are at each other’s throats. Children in an adversarial marriage only inherit the bitterness and damaged personalities that they will take into their own marriages in future. So, for the sake of a health society in future, I will not hesitate to recommend that people call it quits before the painful journey is too far advanced to turn around. Getting out of a painful marriage quickly enough is a journey to healing.

LITMUS TEST 2: Is your spouse a repeat offender in spite of being forgiven repeatedly?

We have heard ad nauseam that “nobody is perfect”. I agree with that adage but would like to extend it with “but everybody can change if they try hard enough”. In any marriage the couple get accustomed to each other’s ways and can end up taking each other for granted. It is this “taking for granted” that makes people blind to the effect they may have on their partner. When we fall in love for the first time we are not normal. We are at the mercy of a hormone known as oxytocin, which is also known as the love drug. Once we settle in a relationship the oxytocin levels recede and we fall back on our socialised selves (you could call it personality as well). As we get used to being in each other’s space our defences give way and some of our dark qualities begin to show. Dark qualities are tolerable up to a point. They are tolerable for as long as our partners accept that “that is the way she/he is”. Certain dark qualities are intolerable and have to be changed, for example, lying, infidelity, financial recklessness, violence (you can add to the list).
Whenever I come across misdemeanours that hurt the other spouse I highlight them and recommend to the offender that they must change. Anything that hurts your partner chips away at the most important ingredient in any marriage: TRUST. Mistrust is a product of repeat offences. Once a spouse does something that endangers trust, accepts responsibility for it and commits to making amends, then that relationship is on the road to recovery. A person who keeps repeating the same offence in spite of being forgiven is not worthy of love and deserves to be dropped like a hot coal. That is another recommendation I do not fear to make in therapy. I often caution people that past behaviour is a predictor of future behaviour. Anything that a person does once is likely to repeated again and again.

This is more the case with repeat offences. This does not mean we are rigid beings incapable of change. Change is possible. What is required is for the offending person to make a commitment to change. Often it is not easy for us to change. A helping hand is necessary. That is why professions like mine exist. So, be aware of the things you do that hurt your partner and make a commitment to change. Flexibility in relationships is a healthy quality.

That is my take on this subject. These litmus tests are not exhaustive. I will probably expand on them as I grow in experience. You might have other litmus tests that you want to add to the list please feel free to do so. Please post your comments below.

© Dr Emmanuel Tlou

Monday, March 8, 2010


We have heard about all sorts of addictions: alcohol and drugs, gambling, sex, pornography, the list can go on. What is common in all addictions is that a person has an overwhelming compulsion (that is, they cannot hold themselves back) to engage in a harmful act of whose dangers they are aware.

I want to add another addiction to the list: RELATIONSHIPS! Think of the following as examples of relationship addictions: A woman who was raised in a family with an abusive father marries an abusive husband and stays; A person divorces a gambler and then marries an alcoholic; A pensioner parent phones her/his married children daily and offers advice on how to run their lives.

All these people are relationship addicts. They cannot let go of a relationship no matter how harmful it is to them. You could proverbially describe them as door mats on which other people rub their dirty feet. Despite all the hardships a relationship may bring, these people stay committed to it and may even kill for it (apologies to Julius Malema).

In this blog I discuss three issues about relationship addicts. First, why they cannot let go of harmful relationships, second, why it is important to let go and, third, some ideas on how to get out of such relationships.

1. Why is it that people find it hard to let go even when they know that a situation is bad for them?

The answer lies in a syndrome that a British psychologist coined codependency. This term, which has got nothing to do with a healthy picture of togetherness that it conjures up, refers to unhealthy, self-sacrificing and, sometimes, self-destructive ways of relating to other people. Codependents are people who are dependent on others for their self-worth and live for other people. They have variously been described as “enablers” or “relationship addicts”. That is, they have a strong sense of being needed and will go to great lengths to please others, even to their own detriment. Examples of codependents would be women who stay in relationships with abusive men, people who always get involved with, or get married to alcoholics, domestic workers who remain loyal to oppressive employers, doctors and other health professionals who go all out to “serve the community”, parents who dote on their children to a point of spoiling them rotten and so on. They are people who allow themselves to stay “trapped” in unproductive relationships and ignore all danger signs in such relationships. Because of their desperate need to be loved and approved, they can be likened to chameleons that take colours from their surroundings and will not be true to themselves – for them others come first and they will subordinate their own needs to those of others. That is why they stay in abusive relationships. They love “till it hurts”, which is a very unhealthy way of loving. They can also be likened to puppets on strings and are wholly under the control of a puppet master (the powerful person in the relationship).

It is not clear how codependency starts and generalizations cannot be made that easily. From what I have seen, here is what I think : It is certainly a learned behaviour. Codependents learn very early in life to put up a front and not be themselves. They would typically emerge from dysfunctional families where there is a lot of suppressed conflict or inconsistency in parenting so that the children never know what to expect. The families of future codependents may (externally) be “model” families in the community but they may have “skeletons in the cupboard” in private. One of the parents may be a relationship addict him/herself such as a dedicated “servant” of the community, while the other parent may (secretly or overtly) be an alcoholic, a gambler or have some kind of personality disorder. The psychological needs of the children of the children in such dysfunctional families may be neglected so that the children develop ways of “attracting” love to themselves. They may do this through pleasing others to the extreme so that as adults they would become addicted to other people. That charm that codependents learn to exude so early in life often makes them attractive to the wrong types: the abusive spouse, an overbearing boss, alcoholics and other drug addicts, and so on. Codependency explains why some women (and men) would leave an abusive partner only to get involved with an equally, if not more abusive, partner. In a relationship pattern like that, abuse has become so internalised that the person cannot define her/himself apart from it – abuse, therefore, assumes a sort of secondary identity. Getting such people to break free is quite a challenge because they will often have self-defeating conversations such as “What will happen to me if I leave this man/woman that I love so much”. Their addiction to others blinds them to the possibilities that exist outside the relationship.

2. Why would it be important to let go?

It is important to let go ASAP because such relationships are like a spider’s web: The longer you get caught in it and the longer you stay, the harder it is to get out. It is important that codependents discover that they have an identity separate from the “host” and they have to allow themselves to experiment with independence. Until they discover that they can still be someone without the host they will become trapped in the relationship to a point where they develop serious psychiatric/psychological disorders. Staying in unproductive relationships psychologically paralyses a person and it becomes difficult to have meaningful relationships with others.

3. Practical advice on how to get out

The first thing – and the most difficult because codependents seldom realize they have a problem – is to acknowledge that one is an individual of worth and will not be anybody’s puppet. Drawing that line will make it possible for the person to realize that they have their own needs which only they can fulfill. Secondly, they must have the courage to disappoint others. They must learn that it is not wrong to say NO! when they do not feel comfortable with doing something for others. Once they discover that saying NO! to someone who matters does not bring the heavens down, they are on the blissful road to discovery and from there on it becomes easier to cut the proverbial puppet strings. Thirdly, they need to be kind to themselves. Making oneself a priority in life is a surefire way to gaining independence. Independence in this regard should not be confused with selfishness. Selfishness is looking at your own needs without any regard for the next person. Independence, on the other hand means you are able to be kind to your own needs while making room for others in your life. A person who is independent in a healthy way is able to engage in meaningful and fulfilling relationships with others. It is only the extreme form of independence which is unhealthy (that is another topic you might want to write about in future).

What I say in the foregoing paragraph may sound easy. It is not. Often people cannot break free on their own. It helps to speak to a psychologist so that the nature of one’s codependency is understood (there are unique dynamics in every codependent relationship) and relevant interventions can be developed.

Thursday, February 18, 2010


“I didn’t know he would be so reckless with money”
“Everything changed since her sister moved in with us”
“He never listens to me, his family’s opinion is the only one that counts”
“This child does not respect me at all; I don’t know whether it is because I am not his father”

Any of these statements familiar? Well, these are some of the things I, and other therapists, would hear from clients during sessions. These verbalisations would typically happen in the context of couples therapy when the couple are at loggerheads with each other and things have become unbearable. I would then ask: “Did you not negotiate about these issues before you got married”? The response would typically be a “No” or one of those “poor me” stares. It is at these moments that I would be reminded of the importance of pre-marital counselling.

Why is pre-marital counselling important?

I like to use the analogy of a used car to drive home the importance of pre-marital counselling. People who are getting married are not brand new. Like used cars, they look perfect and clean but as they start to live with each other and closer inspections are taken, tiny dents and scratches start to show. As is the case with used cars, the other may sometimes feel, “I might not have chosen it had I seen that dent before purchasing it”; put differently: “I might not have married her/him had I known about this problem before we were married”.

In human terms, an equivalent of dents and scratches I refer to above would be emotional scarring that manifests itself as a person’s personality traits, habits, tendencies, communication style, patterns of relating and other conditions of being human. By saying people are not brand new I refer to the fact that all people are a product of their socialisation and social experience. These social experiences that we accumulated through our maturing years have left an imprint in out personalities so that we tend to have consistent patterns of relating that are shaped by these experiences. For example, a person who was raised in a climate of a hostile and conflict-ridden marital relationship may develop hostile and adversarial ways of relating with people in intimate relationships. Contrariwise, someone who grew up in a warm and loving family would not have difficulties establishing trust in an intimate relationship.

Pre-marital counselling is a process by which the about-to-marry couple open their proverbial cupboards so that their spouse-to-be can take a peek and see what is inside. If they do not like what they see, their fears and expectations can be discussed in the safe space of therapy. Couples get to negotiate around the various issues that are known to give rise to conflict in marriage. The advantage of such negotiations is that the couple start to “work” on their marriage before issues become a problem. This is akin to the Setswana proverb that it is easier to bend a twig while it is still wet (fresh or young, that is). Issues that are addressed during pre-marital counselling are less likely to have disastrous consequences if they cop up during the marriage as the statements at the beginning of the blog are unlikely to be heard.

The issues that I get couples to work on during pre-marital counselling sessions include:

• Values – both personal values and the values the couple want to adopt and live by.
• Money: what are going to be the rules of money in our family.
• In-laws.
• Careers.
• Communication.
• Children (especially when one partner would be inheriting).
• Type of marriage contract (in or out of community).
• Personality differences.
• Misfortunes (e.g chronic illness, bankruptcy and so on).

In addition to these, the couple would often have the issues they want to negotiate.

I usually contract six sessions with the couple. The first two would be my individual meeting with either of them so that I get to know them we start working jointly from the second session when I give them feedback on my observations and suggest things to talk about. We would spend two more sessions with them doing negotiations. Often, I recommend that the couple keep a journal of the things they discuss outside the sessions so that we do a thorough discussion of them in sessions. The last session would occur six months into the marriage and focuses on the progress the couple are making on the issues that formed the focus of the negotiations.


Dr ER Tlou


In the years that I have been doing psychotherapy with couples I have come to realise that a significant proportion of problems in married couple’s problems is accounted for by money. In most cases the problem is not about a lack of money but, rather, how it is managed. Individuals in couple relationships often have different approaches to managing money. Money and people’s attitudes towards it, it seems, has become another expression of one’s personality. What is also very apparent is that people’s attitudes towards money develop in their formative years and become piggy-backed on their personalities. For example, someone who, as a child, was raised in a family where money never seemed to be a problem and got used to getting everything they wanted at the time they wanted it, is going to have a different “money personality” from someone who was socialised in a family where money was managed more stringently. If these two individuals were to get married, it is likely that money would become one source of their tension as they have different attitudes towards it and, therefore, different approaches to managing it.

What I always do with couples for whom money is the source of conflict is to sit with them individually and assess the meaning of money in their lives. I would take a detailed history of how money was managed in their families of origin and the kind of feelings and attitudes they have towards money. Once I have an understanding of each individual’ “money personality” I would give them feedback and highlight the different areas where they need to negotiate.

What I emphasise is that they are not going to change immediately, however they each have to work on what it is about them that makes them manage money the way they manage it. The idea is to make each individual take stock of who they are and how their personalities influence the way they manage their money. For example, do they see spending money as a way of reaching out to the other person and seek acceptance; or is money a way of maintaining control in a relationship (there are many configurations to this equation).

While in the end it is often recommended that the couple seek professional financial management counselling to teach them budgeting and related skills, psychotherapy helps them regulate those internal factors (self-esteem, cognition, locus of control) that influence their relationship with money. The objective is to help the couple develop a healthy relationship with money.

What has often worked for me is sending the couple to go and do an inventory of all expenditure items in their lives. Once that is done they have to make a list of items that they will manage jointly (for example, big expenditures such as the bond or car payments) or separately (for example, small items such as telephone bills or garden services). They have to negotiate how responsibilities are going to be apportioned. If this fails, a qualified financial (or debt) counsellor takes over. My role is limited to taking care of the personality side of money management because money management is not rational; it is a highly emotive issue which is why it is sometimes difficult to tell a relationship problem and a money problem apart. Once a couple has separated these two problems and assigns different professionals to address them (psychologist for the relationship and financial expert for money) it becomes easier to manage both.

What are your experiences with this problem? I am keen to hear.

Dr ER Tlou


Lately I have started to observe an interesting trend on my couch. I will call it a trend because I can count with the fingers of two hands the number of times I have seen it. The occurrence would present as follows:

A young (late 20s or just crowned 30) man or woman, glamorous-looking and articulate would arrive in a R400k-plus vehicle for an appointment. The address they put on the file would suggest they are fairly well-off for their age and they are often employees of a blue chip company or would be running their own business. They would project an image of what the media have branded black diamonds. They would have good education and a blooming career with all its appurtenances. The immediate impression they project would be that of a person who has a good life – materially that is.

What I have noticed about many of these young people is that although they are bright and have a good education that propelled them to career success, they take very bad, sometimes self-destructive, decisions in their lives. These bad decisions are manifest in the realm of relationships. Either they are caught up in destructive romantic relationships or they relate with their loved ones in ways that are not fulfilling for all involved. In short, they cannot manage relationships in their personal lives, sometimes in their professional lives too. The bad decision-making often results in unhappiness and self-destructive behaviour such as overindulgence in alcohol and other substances (increasingly not just illegal substances but over-the-counter medicines such as sleeping tablets and pain killers). Overindulgence in substances is often related to other forms of reckless behaviour such as accident proneness and risky sexual behaviour.

This observation has got me thinking: To what extent do young people professional people require life skills education?

My hypothesis is that these are bright minds that have succeeded academically and professionally. Their intellectual advancement, however, has not been matched by advancement in emotional maturity and personality integration. It appears that our education system places a high premium on intellectual development while not paying any attention to spiritual and emotional growth. Young people go to universities to obtain the qualifications and skills required for a good career. They achieve this goal it seems at the expense of a well-rounded sense of self. Their career success seems to be the focus of their whole sense of who they are. Once the professional identity is taken away, they are left with an emptiness and loneliness that changes their life orientation completely.
I am thinking that there is a need for life skills education for young people who are about to complete university so that they are prepared for the transition ahead. On leaving university they discover, much to their chagrin, that life does not have a recipe book. Education provided them with the ingredients and they must mix everything and prepare a meal that they (and those close to them) will have to eat.
What do the young professionals say about this?

Dr. ER Tlou