The service user's perspective is one we rightly aim to integrate
into our work. Yet how do social care professionals draw on their
own experiences of receiving care? Recently, I returned to practice
after working for many years in non-operational areas of social
services. I wanted to rediscover my capacity to engage with people
living different lives from my own.
But things were not as straightforward as I expected. I soon found
out that clients could draw me into territory uncomfortably close
to my own stresses and traumas. Once I was reminded of being a
service user myself, I had my own resistance to contend with as
well.
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Almost 20 years ago, I woke up one morning and, without warning,
collapsed. At the time, I was a social worker in a busy inner
London team but, within hours, I had become a medical "case", at
risk of severe disability. I underwent major surgery and spent many
months recovering, in pain and depression. When I gradually
returned to work, my prime goal was to put it all behind me.
I knew I had locked my memories of that time away from myself, but
returning to practice finally made me re-examine how I had
processed the experience. I had a nagging doubt that crossing the
line from care giver to care receiver had challenged my sense of
power and that, when I recovered, I quickly rushed back to
professional "safety", locking the door firmly behind me. Yet this
didn't sound quite right. It wasn't like me to be unable to reach
the lessons of my own experiences. I needed to know more.
Very slowly, I started to prod at my processing of the event to
understand it better. Carefully, I opened the locked door and
peeped inside. And there it was, the worst feeling of all: the
desperation that never left me, at being trapped inside my own body
and unable to escape the terrible things happening to me.
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It helped me move on a little. Now, I can accept that what I feared
might be denial or paternalism was probably a normal way of
processing this experience, and managing the trauma
psychologically. It makes no sense for me professionally, let alone
personally, to experience this feeling again each time I connect
with a client who wants to escape from the life they feel trapped
in.
I have freed myself to recognise the ways my perspective as a user
are operating in me. I can see that my strong views about the power
of information-giving are the result of the distress I felt at only
holding partial information about the complicated surgery I faced.
I can identify with and tolerate the self-absorption that comes
from deep stress. Perhaps I was mistakenly looking for total
enlightenment from my experiences, but these smaller fragments of
understanding are just as valuable.
Helen Keville is a family mediator and former user of
medical services.
