Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

PRACTICAL GUIDANCE
We all know that this work can be rewarding, engaging, often
moving, sometimes funny, and ultimately very worthwhile. But
personality difficulties shape how a person relates to others,
and so the relationship between a worker and service user can
be complicated. Because people with personality disorders have
often had unhappy, difficult or traumatic experiences with
those who were meant to care for them in childhood, they may
be wary of people who try to help them in adulthood. This poses
particular challenges for frontline staff who work with them.
On first impression,
a service user who attracts
a diagnosis of personality
disorder may appear to reject
help, or to be intent on harming
him/herself or another person.
In fact, the service user who
appears to reject help may be
communicating that in her/his
experience, ‘help’ can be
abusive and should be treated
with suspicion. Rejecting help
cannot be taken at face value.
This makes the work demanding
and stressful for staff.
To be skilled at this kind of
work, a person needs to be
emotionally affected by the
work, but being affected by
the work may sometimes mean
that we are overwhelmed,
upset, or do not function as
well at work as we would like
to. This aspect of working with
people means that services
need to be designed to provide
thinking spaces or reflective
forums, where staff can
discuss feelings in relation to
the task, roles and principles
of the service.
Working with people in pain
or distress is painful and
distressing at times. It is not
always easy to admit to the
feelings we may have
towards people we are
meant to be trying to help.
Most frontline staff
(if they are honest) will
have encountered service
users in relation to whom
at times they felt:
• Frustrated.
• Hopeless.
• Confused.
• Anxious.
• Aware of uncomfortable
parallels between the
service user’s life and
their own.
• Guilt that they are not
offering enough.
• Angry and resentful that
the service user seems
ungrateful.
• Guilt – or relief – that their
life is not so troubled as
that of the service user.
Everyone needs time and
space to recognise, and
process what they are feeling
in relation to their work, and in
particular, in relation to service
users who stir up strong
feelings in the worker. This is
rather like digesting a meal:
we need time to chew things
over, reflect on them, come to
terms with them, and take
in and learn from the
important lessons. With help
from others, we can also work
out what are our own issues,
and what might be an
understandable reaction to
the service user’s issues.
There are many ways of
getting this support.
The work of trying to
understand these kinds of
feelings can be done in
groups, such as reflective
practice groups or group
supervision, or through
discussions with a supervisor
or colleague.
67