mental health social care

Privileged Glimpses (of the bleedin’ obvious)

About this series

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.

Many of the ‘glimpses’ only become obvious once they are explained. Until then they appear ‘counter-intuitive’. To put that more simply they seem to make no sense at all to people not used to thinking in this way.

The real aim then is to help people to examine and in many cases change their basic approach to people who need their support.

As always I’d be grateful for feedback on the ‘privileged glimpses’, either by Email or though comments on the blog.


There is no ‘us and them’

People are just people

People do the best they can with what they’ve got

Coping skills develop slowly

Don’t expect your service user to perform perfectly. You don’t so why should they?

Don’t blame people with disorders for behaving like people with disorders

What people say may not be what they mean

Do as I do – model behaviours we want to encourage in others

Lapse and relapse – two different things

Sympathy is not usually helpful

Risk-free is impossible. Manageable risk is the way to go

Don’t flap

The saviour fantasy

You’re probably not an emergency service – don’t try to behave like one

Hanged if you do & hanged if you don’t – a duty of care myth

The word ‘support’ is meaningless in and of itself

Challenging behaviour means….

Learned behaviour

Unhelpful thinking

“It’s just behavioural” – a workers’ excuse for lazy thinking about service users’ needs.

Who put us in charge?

mental health

5 easy tricks to keep you happy

errorWe all know about sleep, diet and exercise. That’s not what this post is about. They’re just the basics – the essentials of life as a biological organism. Everyone knows that stuff. This is about the less obvious but really important strategies that most people don’t know – and never will. This is about attitude and behaviour.

Develop a philosophical approach

Too many people take things personally. If someone disagrees with them they think it’s an insult and they come out fighting. Another driver cuts them up at a junction and they act like an angry bear all day long. They leave their mood, their happiness and their quality of life to be decided by other people. Their emotions are driven by chance in a world so full of mishap and rudeness that it’s inevitable they’ll get angry or upset as a result.

Understand that the world is full of ingratitude, unpleasantness and downright hostility. That’s just how it is. If you go around acting as though you can only be happy if everything works just to your liking you’re not going to be happy very much.

Instead use life’s mishaps as opportunities to show the world just how much better you can be. You control your mood – not the inattentive shop assistant or the impatient driver who thinks their time is more important than yours. Make up your mind to stop pretending that anyone else is in charge of your emotions. They may be angry or offensive but you don’t have to join in.

Lose the positive mental attitude (or at least temper it)

There’s nothing positive about positive thinking. At least not when it becomes so blinkered that you can’t see past it. The glass is neither half full nor half empty. It’s just a glass with some water in it.

Make it a habit to think about every situation as it really is without needing to put a spin on it. Pessimism leads to cynicism and hopelessness. Optimism leads to blind faith in a world that can never be as helpful as we want it to be.

Realism means seeing the world for what it really is, honestly assessing our own strengths and weaknesses and coming up with realistic plans to face whatever life throws at us. That’s far more useful than blindly running over the cliff with the insanely positive opinion that we can fly.

Cut out the small talk with the small people

Do you work with others? Do you meet other people regularly? Are you a part of a club or organisation? The chances are that you answered yes to at least two of these (probably all three).

Look around you and listen to the conversations your friends and colleagues have most often. How many of them are inspiring, uplifting conversations about potential and about challenges to be overcome or rewards to be earned? How many are long, drawn out moans and gripes about how badly the boss treats us all or why there’s never enough time to do the work expected of us? I think that last one is particularly ironic, given the amount of time people spend moaning about their lack of time.

Make it a habit not to join in with these unhelpful conversations. It’s OK to take part for a minute or two to get a sense of what’s going on but then go and get on with whatever you have to do. Your colleagues may well continue the conversation for another hour or more but they won’t be saying anything new and they certainly won’t feel any better at the end of it.

Get involved in something meaningful

We all like to feel as though we’re of value. Nobody likes to feel useless and yet so many people ignore the potential they have to really contribute.

Develop an interest that lets you contribute to something of importance. Ideally get involved in something that you define as important. As Albert Ellis put it..

Humans are happiest when they are involved in some project or activity that they define as more important than themselves.

Do something that you can be proud of.

Give yourself permission to be wrong

Nobody’s perfect. Everybody makes mistakes. That’s part of being human and try as we might we can never change that. So don’t act as though you’re somehow different from the rest of the species.

When we get things wrong we have two basic choices…

  • We can learn from our mistakes and grow
  • We can get angry at our failures and shrink

Give yourself permission to get stuff wrong – that’s an important route to learning and personal growth. Be prepared to admit it and seek advice from others when you mess up and make a habit of encouraging others to do the same.

Interestingly enough if you start admitting your own mistakes to others they very quickly notice and start being honest about their own mistakes with you in return. You start having honest conversations. You get to solve problems and put stuff right. Everybody wins.

What have you got to lose?

Try these five ways in your life and do, please let me know how you get on.

Go on – you know you want to.


Models of mental health and disorder

The world of mental health care can be confusing – especially for those new to the topic. Often the different theories and professional approaches seem to contradict each other. It’s almost as though different workers speak different languages,

That’s not quite true but they do often come from different theoretical perspectives. That’s why, for example, a social worker and a psychiatrist will give you two completely different explanations for the same person’s problems. They’ve been taught radically different ‘models’ that they use to understand mental health and disorder, its causes and its treatments.

This little table isn’t intended to cover all the different models in depth. Instead think of it as a very basic list of models that can guide you in understanding why people focus upon different things. There’s more to it, of course but it’s a start for newcomers trying to get to grips with the contradictions they come across in practice.

The Care Guy Models of mental health and disorder


I just love this stuff

Today I was in Halifax in beautiful W. Yorkshire. It was great.
I arrived last night and met up with a former colleague for a catch up over a curry (& beer of course).


Then today was spent with around 20 of Calderdale’s finest mental health & social care workers talking about psychosis and interventions for people who hear voices. It’s amazing what a really enthusiastic group can get through in a single day. We covered basic principles of psychosis, a little philosophy of mental health care, models of understanding and normalisation in the morning. This afternoon was devoted to meaningful activity and validation, socratic dialogue, delusions and perceptions and principles of risk. These people really got their money’s worth today!

The group was great fun to work with and they really seemed to enjoy the day. Hopefully they’ve got some useful new skills to take away too.

All in all it’s been a really successful day. And now it really must be ‘beer O’Clock’!

What a cracking day!


#TwentalHealth (Twitter) awards

How cool is this? I’m joint runner up in the 2013 #TwentalHealth awards in regard to my Twitter account @StuartSorensen. It’s an honour I share with the wonderful @MrsGracePoole whose twitter feed is well worth following if you’re into mental health and/or nursing.

The winner in the nursing category was @Nurse_W_Glasses, creator of the now extremely famous 20Commandments for mental health workers. I’m especially please to see that NWG won the nursing category award, having interacted with her online for some years now and even collaborated on a longer elaboration of her 20 Commandments a couple of years ago.

So well done to NWG for taking the big credit – an honour she richly deserves. And congratulations to Grace (AKA Alison) who, like myself has the honour of displaying the 2013 runner up badge on our blogs and online profiles.
twental health 2013 runner up


I’m in the top 10!

Now that was a surprise. The Cision UK top 10 UK health blog index has this blog at number 8. How cool is that?

In fairness I strongly suspect that it’s more in recognition for my archived mental health and social care material than for my current stuff. But hey, who’s complaining?

It’s good to know that people still remember the old blog.

mental health

I wonder if this is true

Faith healing GP Accusations have come forward that a Staffordshire Dr. told his patient God would heal her & to stop taking her psychiatric medication. The GP denies any wrongdoing and claims that the allegations represent an attack on his Christian faith.

Whether or not this particular GP is guilty of such serious misconduct is a question yet to be answered. However it wouldn’t be the first time such medieval recommendations have been made in UK. The last few years have seen UK psychiatrists like Rob Waller refer psychotic patients for exorcism, several deaths resulting from exorcism worldwide and an Archbishop calling for exorcism of ‘the mentally ill’ in the House of Lords.

It’ll be interesting to see how this plays out.