We nurses aren’t perfect. We generally spend our time trying to sort out problems that we didn’t cause. That’s more than most people do. It’s more than the majority of our critics.
But no matter how hard we try, sometimes we fail. Sometimes we don’t fail but people place such unrealistic expectations on our practice, make such unrealistic demands of us that we face criticism, insults, even threats of violence for not living up to the demands of others.
People can disregard our efforts, they can slander us on social media and dismiss us as incompetent, callous fools if they like. That’s their right…
This series of blog posts first appeared a few years ago on a now defunct blog called ‘Care Training’. It was inspired by the training maxim of ‘making the unconscious conscious’. It is intended to take what really ought to be the most basic principles of health and social care and put them down on paper. The series isn’t only an exercise in stating the obvious though whatever the title might suggest. It’s actually intended as a philosophical foundation manual for workers and informal carers to help them get their care ‘on track’ and then to keep it that way.
Don’t blame people with disorders for behaving like people with disorders
One of the fundamental themes throughout almost all of my writing is the idea that there is no ‘us and them’ and that people are just people. We are all fallible and we are also all capable of improving ourselves. This means that it is never OK to assume that people with mental health problems can never overcome them. Those of us who work in mental health services have an obligation to work toward improved functioning and coping skills development. That obligation includes a duty to believe that the people we work with are capable of change given the right circumstances, opportunities and motivations.
Unfortunately there is a downside to this approach. Some mental health workers use the belief that ‘there is no us and them’ to justify unrealistic expectations of their service users. It is true that people can achieve great things regardless of diagnosis but it is also true that people with mental health problems are unlikely to function as well as those who are free of such problems in the short term. It takes time to overcome our difficulties and there is no value (or logic) in expecting people who have problems to act as though they had not.
And yet some mental health workers, of all grades and professions seem unable to separate potential coping skills from current achievement. They expect their service-users to behave as though they had already overcome their problems and then blame them when they do not. This is not only lazy thinking, it is evidence of severely limited understanding of mental disorders, the process of recovery and the role of mental health workers.
When we blame our service-users for behaving like service-users we recreate the same sort of invalidation that brought many of them into our care in the first place. Rather than assisting people to develop better coping strategies this attitude further damages service-users and serves to trap them in their existing circumstances and psychological difficulties. Our job is to help people to develop beyond their problems, not to judge them for having those problems in the first place.
Don’t blame people with mental disorders for behaving like people with mental disorders.