Tag Archives: support work

Privileged glimpses 13: The saviour fantasy

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.

There’s an irony about health and social care work. More specifically there’s an irony about health and social care workers. The workers who want to save the world are the ones most likely to cause harm, to themselves and to other people.

Saviour fantasistIn the trade we sometimes talk about the ‘saviour fantasy’. It’s an admirable quality in new and inexperienced staff but it’s unrealistic, dangerous and much less positive among more experienced workers. Those who come into this line of work expecting to make everything alright for everyone they meet tend to be committed and hard working. They have the potential to be excellent carers and advocates for those they work with. But those who hang on to their saviour fantasy over time demonstrate something else as well. Experienced saviours also demonstrate an inability to learn and that makes them dangerous.

We cannot please all the people all of the time. Nor can we ever know everything and we’re not able to do everybody’s jobs. It’s enough to ensure that we get our own part of the equation right. When we try to improve upon the work of others we risk meddling in what we’re neither trained nor sufficiently well-placed to understand.

Saviours are also much more likely to burn out themselves. If they expect only good things for their clients and take too much personal responsibility for ensuring positive outcomes for everyone they quickly become crushed when reality bites. There are many, many reasons why things don’t always work out in mental health care. Saviour fantasists blame themselves and the remorse they feel can be overwhelming.

Don’t be a saviour fantasist. It damages both service users and workers alike.

Privileged glimpses 12: Don’t flap

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.

More haste – less speed.

There is a very real responsibility in social care work. The best workers are aware of that and strive to live up to it. They know that what they do matters and they take their work seriously.

Unfortunately though that sense of responsibility can become a problem in itself. The more seriously we take our duties the more likely we are to become stressed about them unless we also learn how to manage our own anxieties. Some of the most caring and compassionate people I know are also the ones most likely to turn into headless chickens the moment anything out of the ordinary happens.

The problem is that the more we flap the less effective we become. Our emotional over reaction is contagious too. If we lose our cool then our colleagues are more likely to do the same. Not only that, the people we care for are just as susceptible to displays of emotion themselves. Uncontrolled displays of anxiety from workers serve only to unsettle the environment even further. Instead of having one problem to deal with over anxious workers quickly find themselves stuck in the middle of a whirlpool of unrest and that just makes their work even more difficult. And they brought it upon themselves with their own lack of self control.

Perhaps more importantly it’s not fair on the people who rely upon us – the people in our care.

So the message here is simple. This ‘privileged glimpse’ really is bleedin’ obvious:

Don’t flap!

Privileged glimpses 10: Sympathy isn’t usually helpful

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.

I spoke with a colleague recently about a difficult situation she had to deal with at home. It doesn’t matter what the situation was. It’s enough to say that this lady considered that she was being treated unfairly and unreasonably by a family member. So far as I could tell (having heard only one side of the story) I’m inclined to agree.

The temptation was to sympathise with her. That often feels like the most human, most compassionate response to another person in distress. It’s how we show that we care, how we demonstrate understanding and, perhaps most importantly, it maintains rapport. When we sympathise with people we usually find ourselves ‘on their wavelength’ and that feels good.

Unfortunately though, however good it may feel sympathy is far from positive. In reality it’s usually very destructive. Here’s why….

When I sympathise with you I’m really telling you what you already want to hear. I’m reaffirming what you already think:

Sympathy empathy“Yes it is awful and you’re quite right to feel that bad about it.”

Sympathy locks us into the same emotions and beliefs as the other person and that’s not a good place to be. I can’t help you to move on and solve problems if I’m wearing the same emotional blinkers as you.

Of course, it is true that people really do have a right to feel bad when things don’t turn out as they would like them to. But it is also true that you don’t have to feel bad as well. You’re not obliged to join in.

If you resist the urge to sympathise you can keep a clear head without risking being drawn into the ‘doom and gloom’ thinking of the other person. This means that you will be free to explore other explanations and solutions. You can problem-solve and you can encourage others to do the same.

Sympathy acknowledges that people are right to feel bad and that traps them:

“Oh poor you. I’d feel awful if that happened to me.”

Empathy is a much, much more helpful proposition. Empathy acknowledges that people have a right to feel as badly as they want to but then it asks:

“But why would you want to?”

Empathy acknowledges and validates problems and emotions but then moves on to find solutions. Sympathy merely validates distress but offers no help to overcome it. In fact sympathy risks prolonging distress.

Don’t ‘do sympathy’.’ Do empathy’ instead.

 

Privileged glimpses 6: Don’t blame people for their disorders

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

l_300_168_BFB62138-883B-4070-8F84-F868E3CC5219.jpegOne 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.

 

Privileged glimpses 3: People do the best they can with what they’ve got

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.

sweet shopImagine a small child in a very large sweetshop. The lights are off and it’s completely dark except for a single spotlight illuminating a tiny piece of shelving. On the shelf, visible in the little pool of light are three bars of chocolate. One bar is milk chocolate, another dark while the third is white chocolate. That is all the child can see.

The child has one simple instruction…

Take your pick…

Obviously the child will choose one of the three chocolate bars he can see. It doesn’t matter what other treats might be in the shop because he can’t see them – he doesn’t know that they are available options.

This little post isn’t really about chocolate bars and children in sweetshops though. It’s about social care service users and the options they have available.

The sweets in the shop represent coping strategies. They’re behaviours. Choices about what to do in different situations. And just like the child in the sweetshop service users (along with everybody else) only choose the options, the behaviours that they know about.

So if someone you work with makes poor choices that’s not necessarily because they don’t want to do better. It’s more likely because they either don’t know what else to do or because they don’t think that other options will work for them. Many people understand intellectually about good coping skills, socially acceptable behaviours but don’t believe that they will be given the opportunity to make different choices work for them. If they’re used to being treated with mistrust they won’t believe that the truth will work for them. If they’re used to being ignored they won’t believe that not drawing attention to themselves will meet their need for human contact. And they may well be right.

So, just like the child in the sweetshop they take the best option available to them.

They do the best they can with what they’ve got.