Front Line Focus: Think yourself better?

With the recent publication of Rhonda Byrne’s The Secret it seems that the power of positive thinking has gone mainstream. Like attracts like is the mantra by which to live our lives. Therefore, negative thinking can provide the right environment for ill-health to prosper. One of the main tenets of cognitive behaviour therapy is to challenge cycles of negative thought that informs the behaviour of many people in the mental health system. No more so than in residential care.

A person’s negativity comes from feelings of unworthiness. As a child we may learn that we receive more attention from doing something bad than from doing something good. Even if it is a slap round the head any attention is better than none. To a child, being ignored can equal abandonment. If the times we’re called “bad” outweigh the times we’re called “wonderful” slowly we start to believe that perhaps we really are bad. The Christian doctrine of “original sin” supports the notion that humankind is inherently sinful. Political solutions to the problems of human nature pose a dichotomy. Conservative thought emphasises discipline in order to restrain our wickedness while liberalism promotes the freedom of humankind in order to release our inherent goodness.

Many mental health service users have not only had punishment and abuse as a basis of their upbringing but also abandonment, either total and literal or being secluded for hours on end in a locked shed or room. In residential care we constantly have to gently challenge people’s feelings of unworthiness and hopelessness. The existential fear that arises is visceral and horribly infectious.

Yet sometimes there is a twist – the comfort of the familiar. If negative thoughts and behaviour is a person’s modus operandi, the fear of changing a life and mode of being is sometimes greater than the fear of staying with what they are accustomed. Added to which residential care can be a welcome sanctuary from the perceived iniquities of society. To the dismay of residential care workers this may be viewed purely as a fear of becoming well. However, this is a gross simplification of the complexity of feelings and beliefs that underlie their assumed entrenchment.

Thanks to the drug companies, many have bought into the idea that emotional distress is simply a chemical malfunction. But this detracts from the idea of people retaking control of their lives. But where’s the money in that?

Nigel Leaney manages a mental health residential service

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