Our General Manager often says that when we find our clients to be challenging, that’s how we know that we are targeting the right people for our support. Support worker, R, talks about why he believes even the most challenging people deserve unconditional support.
‘I have known ‘Heidi’ for a few years now and I have had some pretty rough times with her. I have been manipulated and blamed for all sorts of silly things; shouted at and generally just treated very poorly on many occasions. The opportunities for me to take offence and take things personally are numerous! It is probably for the same reasons that many people in the community would consider this individual a very, very bad person.
And yet I feel very strongly about the need to look beyond this behaviour because I do believe that through the opportunities made possible in my job, I have seen more sides to this individual than just the ‘bad’ stuff. Unfortunately for most people, this is all they see. I think it is fair to say that most organisations who have spent any amount of time trying to support Heidi, have ended up feeling manipulated and lied to in such a short space of time that they never got the chance to experience a more sincere exchange with Heidi. They are always having to re-visit and challenge the previous behaviours in order to try and make a positive move forward. I think it is only right to talk to Heidi about her behaviour but unfortunately this most often leads to further confrontation and the communication and rapport breaks down even further.
I found it very interesting recently when I was with Heidi at an appointment. As part of the session Heidi was asked a series of questions which were all linked to how she relates to others and copes with the day-to-day. All the questions simply required a yes or no answer, such as: ‘Do you struggle to empathise with other people’s feelings?’ Heidi answered yes to this question and there were many more similar questions. Through the questioning it became clear that Heidi is very aware that she struggles to relate to how her actions may affect other people. I think that it is only after Heidi has had to explicitly face the negative impact of her behaviour, such as a worker being visibly and verbally upset, that she is then able to calculate that she may have acted inappropriately. I don’t think she is very aware of the emotional impact her behaviour is having at the time. Taking this into consideration when faced with the negative impact of Heidi’s conduct, I now view these incidents as an opportunites to focus, not on ethics or the action in isolation, but on what was going through her mind at the time of the incident and to question what things she was aware of at the time. I tend to find that making a reflective discussion about her is always far more effective than trying to make her feel guilty, which essentially involves talking about another person.
I also see a barrier emerging for Heidi. Since getting to know more about her reputation in services I am noticing that she may not always get treated equally. It’s like ‘a boy who cried wolf’ issue. I realise this could be quite a grey area but first let me explain the following example. I recently liaised between Heidi and her GP service to organise her medications. Unfortunately Heidi had failed to organise a pharmacy to work with and from what I could tell, there was no real reason for this. Eventually Heidi and I made some progress but when I went back to the GP service I was told that the prescriptions were now out of date and had been destroyed. Even though we now had a pharmacist on board Heidi was not going to get a new prescription. I was told that Heidi must come to see her GP (which is only available to her one day each week) before they would give her the two types of medication. For one of the drugs this was entirely fair and was in the interest of safety due to issues surrounding risk, but the other medication wasn’t affected. Heidi had been previously prescribed this medication for a long time and there wasn’t actually anything stopping the service from issuing a new prescription; they had just decided she needed to engage before she could get anything at all. After I challenged them about this they agreed to distribute this particular medication to Heidi but if I hadn’t been there I’m guessing she would have been denied it.
I find it no surprise that the same person making these decisions has regularly experienced a demanding and argumentative Heidi on the other end of the phone. I don’t like the fact that individuals have to be on the receiving end of such challenging behaviour but does that really justify cherry picking some new conditions by which an individual can be treated for their mental health? If Heidi didn’t have a support worker, as I imagine many other ‘Heidi’s’ across the country don’t, that is exactly what would have happened. I don’t deny that working with Heidi is challenging, but I feel deeply passionate that she should be supported with the same level of concern and flexibility as any other person. Only that way will Heidi build a bank of trust with services so that she can move forward to develop a more positive way of interacting with those services. This will undoubtedly pave the way for huge changes for her in the future and together we will keep working towards that, one day at a time.’
#Simon