It’s not why we trained

It was so much easier to blame it on Them. It was bleakly depressing to think that They were Us. If it was Them, then nothing was anyone’s fault. If it was us, what did that make Me? After all, I’m one of Us. I must be. I’ve certainly never thought of myself as one of Them. No- one ever thinks of themselves as one of Them. We’re always one of Us. It’s Them that do the bad things.

Jingo by Terry Pratchett

There are lots of ways of thinking about organisational culture and organisational change. One I like is called ‘Appreciative Enquiry’. Like all ideas it is useful in some ways and limited in others, so I am not going to go into too much detail here.

Briefly Appreciative enquiry sees organisations as a shapeless organism in a constant state of development. The system constantly shapes and adapts itself to its environment. The people form the system, and influence the nature of the organisation particularly through their behaviour and through the language they use. This means that the culture of an organisation or a profession becomes something that is constructed by the people who are part of that organisation in the course of their conversation.

One idea from this school of thought is if the system or culture of an organisation or a profession exists, then something is working and something is giving, preserving, nurturing and encouraging the life of the system. This seems to me to be a healthy way to look at developing human systems.

However, on Twitter anyway, I don’t really get those stories about mental health. Mostly because a lot of people feel a lot of things are not working well. This means that conversations most usually go:

A valid criticism of mental health practice, is followed by:

“It’s not why we trained” or “Think of it from my point of view” from someone working in the system, which is then followed by:

  • A list of out of ‘out of our power’ organisational constraints that might make the professional behave that way, or
  • A list of the ways that the professional might be thinking that makes them behave that way

This moves us towards a way of thinking called Constraint Analysis. In this way of thinking, it is possible to ask questions to work out which set of limitations are causing constraints, which mean that the system is not as able to deliver the things it might want to. This can also be a useful way of looking at organisations.

It might be quite interesting for me to play around with these questions on Twitter and see what happens to Mental Health Professionals when they get asked organisational system level questions!

It’s just that there are other ways of thinking about the language used and the effects that that language has in a social context. If we think about mental health systems as being strongly bound to systems of power and oppression, both historically and right now, then thinking that came out of civil rights movements is relevant and interesting too. It is important here that anyone who’s used these linguistic moves takes a step back, and gets ready to think about the impact of the discursive moves they make and where they learnt it. It is never easy to look at your place in a system that may not use power wisely and even harder to look at your place in a system that indeed may not be even designed to use the power it has to support and help the people it claims to support and help. I guess “thinking into” the system and your role in it is particularly hard if you are a professional that really wants to help and believes in that role wholeheartedly. So, if you are reading this my request is that you try and disconnect things you say from repeated patterns of interaction over time and across different people. After all, it is likely that your professional culture taught you to say and see things that way.

The above examples could be seen as a tactic of misdirection that deflects attention away from complaints about the abuse and wrongdoing of those in power and towards a different topic that does not challenge those interests. This is called derailment.

There is a pretty good argument that when mental health professionals use this when they are talking to people who are criticising the system in which they have a position of (relative) privilege they are doing this to unconsciously uphold practices of institutionalised power and oppression. Perhaps discussions of why things aren’t working well are not about you if you are a mental health professional, perhaps people are commenting on or talking about a set of power relations. Personally, I find the “Think of it from my point of view” response particularly unpleasant, as it inverts the power dynamic of care. People who are looking for help after all may not feel that they have the right to be looked after well, or may feel (or have been told) that they are not good at caring for others or taking others perspectives. It’s quite an attack on the person as well as making unsubstantiated judgements on the rationality of their argument.

So perhaps if, when I am tweeting. I mention that ‘It’s not why we trained’ or ‘Think of it from my point of view‘ is very often a derailment, professionals might want to stop and think, especially if that makes them feel defensive. And don’t be surprised if my response is to put it back on you, by saying, “If you aren’t doing what you trained for, what steps are you taking to change that?”. If you are not happy with your working conditions and are not able to do your job, it’s your role to get involved in activism or your trade union to change that. After all, I am not a mental health professional, you are paid to solve those problems, so it’s your problem to sort out, not mine.

By the way, there are professionals on Twitter who I really rate. To be clear they never use those phrases. They acknowledge the problems, call out the problems, clearly state how they try and avoid being part of the problem, take on feedback about what the problem is and take clear steps to not be part of the problem. Alternatively, they just say what they are doing about the problems.

In addition this is a useful website about derailment, if anyone wants to know more.

Author: Valid Consent

Promoting trauma informed care

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