This week I thought I would write about one of the lessons I have learnt over the years supporting people with their own mental health challenges and it is a bit of a cautionary tail. That ultimately warns against the risk of taking too much on for someone and in the process deskilling them.
I have had at least two long periods of my life supporting someone living with me, that were at the time struggling with mental health problems. And on both of those occasions I have made the mistake of trying to help the, and in actual fact I have helped to erode their confidence and skills. I hope that now I am a little wiser I would be able to avoid it in the future.
It starts off absolutely from a place of love. The person struggling can’t find the motivation or energy to carry out the regular task. Perhaps they aren’t eating much or maybe they have stoped making phones calls in an effort to avoid speaking to people.
In enters the caring friend or family member. You cook them a meal which they barely touch but you feel better they at least ate something. You do their weekly shopping as they don’t want to leave the house and after all you had to go to the store yourself. You make that phone call to deal with an urgent letter in the post. And while you are there you have a quick tidy around, so it is one more thing off their mind.
What starts out as a one off, or perhaps just a couple of days quickly turns into a week or longer and then you run the risk of becoming stuck in a pattern that might strain your relationship and harm the other persons independence.
Whilst all this is done out of love you are often unconisucly taking away that persons skills and confidence. This can lead to the person struggling for longer or in the worst case never really fully recovering to their previous norms.
I have seen it people get stuck in a position where they don’t feel able to do the things they did before. Where they end up isolating themselves further from the world. Where the mental health issue takes more of a hold because there is nothing the challenge it.
From my experiences of supporting someone with mental health challenges I have found it helps to think about like this.
Emergency First Aid.
There is absolutely a time and a place for lavishing someone with care and love. Perhaps they have experienced a loss or are struggling with a difficult time. (Difficult times don’t have to be caused by external events, in the world of mental health internal events can be just as impactful.)
At these times I don’t hold back from doing anything I can think of to help. It might be something as simple as reaching out for a conversation, or it might involve cooking, cleaning, looking after the kids.
I have learnt to offer first. But also learnt people are reluctant to accept help so make it easy for them to say yes. If you think maybe taking them a meal could help, consider just turning up with something prepared, it is much easier for someone to say yes to you if they think the effort has already been spent.
Remember this first aid is all about the other person so don’t be offended if they turn you down or send you away. You can only try your best if they decide that is not what they need then you have to accept that decision, it is their life.
Beyond First Aid
I think the SMART goal setting approach works very well here in two ways. Either as a measure for you when you think about support you can offer but also more importantly as a tool to encourage the other person to start taking back control.
SMART stands for setting goals as being:
I have often come across this tool in the workplace, but have found it work well when supporting those I care about.
An example of supporting someone else with SMART Goals
Specific – I will bring you 7 homemade meals for the freezer.
Measurable – I will make sure you have at least one meal a day for the rest of this week
Achievable – if I batch cook a couple of options and portion it out then I can easily achieve that within my other commitments.
Relevant– I cook regularly anyway and you have a basic need to eat so relevant to my skills and your needs.
Time bound – I will come by tonight with enough meals for the week.
The pitfalls of not using SMART when supporting someone.
Specific – If you want to help someone but are vague in what you are offering it is hard for the other person to accept or decline. Statements like I am here for you, let me know what I can do, whilst well intended won’t always be met with acceptance as if the other person is in a hard place they may find it difficult to know what they need.
Measurable – If you can’t be clear when you have provided your support or if the other person isn’t clear on when finished helping it can leave either or both of you in a bit of a no mans land. Not certain if you have helped or not certain if more help is coming.
Achievable – You should always only offer what support you can without it being a detriment to your life or mental health. You can’t save someone from quicksand by jumping in with them. You need to offer support that you know can be achieved successfully and still safeguard your happiness. If you maintain a place of strength you will be better positioned to help them. No matter how much sometimes it feels like jumping in is the right answer don’t.
You also don’t want to set unachievable goals and let the other person down. You or they will not feel good about it.
Relevant– relevancy plays two ways here. Relevant to your skills and relevant to the persons needs. Think about what could help that you are good at. Good not perfect as we know perfect does not exist. This factor will significantly impact what support you offer.
Time bound- the benefits of making support time bound are two fold. You both know when the support has been delivered. It will set a clear expectation with the the person you are helping, as to when they need to gear back up or find another long term solution. It is extremely important support doesn’t just muddle on Indefinitely. This is when the greatest chance of the person losing their skills or confidence can occur.
Review and Reflect
Throughout offering support you should regularly check in and test if it is helping and if it is still needed. You may have set out to do something for a week or until the end of the summer but things can and will change. You should sense check every now and again if you think you could end the support early, (Hey you are doing so much better now do you want to do your own shopping next week?) You should always be clear if you plan to stop support early.
You should also sense check if the support needs to be extended. There should in my view a specific change that has caused this. If you decided to do something for a week and nothing has changed but you are just feeling guilty the week is coming to an end that is not a reason to carry on support. You made an assessment you should stick by it. That doesn’t mean you can’t try and find a different answer for further support.
If something has changed (perhaps they were due to have a cast off and the hospital have delayed it or perhaps they had another life event, or perhaps they have struggled with an additional element of their mental health) you must revisit the SMART support setting, to check the support still meets all the criteria.
Giving someone SMART goals to get them back on track.
And the other way I find SMART can help is getting the person back on track. It is a great tool to help them set Specific,Measurable, Achievable, Relevant, Time bound goals and take steps back to their wellness. Things to bear in mind when doing this.
Specific – avoid vague goals like let’s get back to some normality, or how about you do something today. Make them specific. Tomorrow why don’t you get up have a nice shower and get dressed.
Measurable– they should know when they have achieved the task. You could even employ a wall chart, tick list, journal approach to track completion.
Achievable – this again is so important small achievable steps. Don’t set someone the task of having a nice shower if there is no shampoo in the house, and don’t over stretch the goal. It is much better to take small steady steps. Equally though I am a great believer in challenging ourselves. Some small challange is good to build confidence and belief in yourself. So you wouldn’t for example say to someone that has been running five miles a day for months perhaps tomorrow you should run 3 miles. Like wise saying to someone that has spent days in bed they should get up, get dressed, go out shopping, come home and cook could be all too much.
Relevant– goals here should be relevant to the person. Don’t set goals that are not going to help them achieve the over all aim (which for me at least is always about being happy).
Time bound – giving a Specific time in which to complete the task helps to make it achievable, measurable and helps to allow for preparing before and reflection after. So decide in advance when is a good time to complete the task. How about you go to the shop in the evening when it is quiet.
Helping for us such a natural thing to want to do. We just need to be careful in that helping we don’t hinder.