Most staff are well-intentioned

And then Jack chopped down what was the world’s last beanstalk, adding murder and ecological terrorism to the theft, enticement, and trespass charges already mentioned, and all the giant’s children didn’t have a daddy anymore. But he got away with it and lived happily ever after, without so much as a guilty twinge about what he had done…which proves that you can be excused for just about anything if you are a hero, because no one asks inconvenient questions.

Hogfather by Terry Pratchett

Most staff are well-intentioned‘ is a phrase which comes up over and over again. A tweet has just come up which, for instance, says ‘excellent blog on how, even with the best of intentions, we still often let down sexually exploited children’. This phrase is beginning to make me extremely angry.

The world is a dangerous place, even though for the most part many people do not experience it that way. The dangers and its harms it holds, like its joys and blessings, are not equally distributed. It is a more threatening place for some than it is for others. Nevertheless, each person is vulnerable, to adverse events or acts of cruelty that may affect them alone, or touch upon a group that they form a part of.

What comes to me out of these sort of thoughts is a sense that our joint humanness is founded on our need to trust in one another, in ourselves and in the world. Surely, when people have had their trust betrayed, our collective humanity is re-established only by rebuilding that trust. Therefore, in order to be fully human, and to create a world where we do not accept atrocities, we must dare to make an honest attempt to heal the harms that do happen, even if that attempt does not work out. Surely, if we do not reach out to one another we are all discarded in a terrible aloneness. Indeed,each and every one of us are lost, even those who seem safely marrooned in the world where danger has not yet touched them. These people also remain exposed to the possibility of what might happen or what others might do, although they may remain unaware of their own vulnerability, or heedless of the risk that they may well be alone with what nightmares may come should others not help them at their point of need7.

So, although I agree that when we are faced with the most difficult and intense experiences of human life we may, in our total disorientation, not know how to avoid doing harm, I outrightly reject the glib phrase ‘most staff are well intentioned‘. I think that phrase is one that seduces everyone into not expecting too much. I think it is a phrase which asks us to accept that; as horrors exist which profoundly distort human relationships, as these forms of brutality should be completely intolerable within the human community, it is also intolerable for us to expect those who choose to offer help to focus their minds on those cruelites. It is a phrase which doesn’t just understand that it is hard to stay with pain, but which requires us to be too understanding of our instinctive tendancy to find ways to block comprehension.

Captain Quirke was not actually a bad man: he didn’t have the imagination; but he dealt more in generalised low-grade unpleasantness which slightly tarnishes the soul of all who come into contact with it- rather like British Rail

Men at Arms by Terry Pratchett

This delibarate and delibarative blocking of sensibilities and responsibility is far too infrequently questioned in public discourse about a range of institutions: prisons, refugee detention centres and mental health. Mental health is particularly problematic as it claims to be about help and support, unlike the other institutions which are, perhaps not overtly, declared arenas of inhumanity and punishment. I read a tweet by Allen Francis about mental health care, which went like this:

Worst career moment. 50 years ago I had to watch a therapist induce vomiting in a man watching gay porn to ‘cure’ him. We’ve come a long way.

and in a comment which explicitly links abusive behaviours by staff and previous traumas, in the second chapter of The Body Keeps the Score, Bessel Van der Kolk writes

After she refused to eat for more than a week and rapidly started to lose weight, the doctors decided to force feed her. It took three of us to hold her down and another to push the rubber feeding tube down her throat, and a nurse to pour the liquid nutrients into her stomach. Later, during midnight confession, S. spoke hesitently about her chidhood sexual abuse by her brother and uncle. I realised then that our display of ‘caring’ must have felt to her much like a gange rape.

These respected people were taking part in actions which they now choose to recognise were causing physical and psychological distress in situations where their patients were utterly powerless. This is a betrayal of trust, a further example of human cruelty. They do not strike me as people who enjoy the experience of power play for its own sake. Yet they undertook those actions, and judging by their writing, to varying degrees do not accept those actions as ones that they were actively responsible for. This behaviour is not the mental life of someone with ‘good intentions’; it is the mental life of someone who can make the suffering of others just distant enough that they can live well with the violence that they themselves enacted.

I expect people who are entrusted with the care of others to do more than engaged in a complex form of dissonance where they disengage from their own actions, while simulataneously acknowledging that they took them. I am remembering a time when I said something harsh to a Mental Health Nurse on Twitter who had previously commented that he had been involved in forcing injections of medication when people were in psychiatric detention in the past. I also remember that people comforted him after my comment by passing their opinion that he was a ‘good nurse’. I wonder what atrocity would be beyond a ‘good mental health nurse’ and what brutality woud be beyond the limits of our acceptance. It is not possible for me to believe that mental health nurses are ‘well intentioned’ when I trace with diligence the convoluted path of the ways they talk about what they do; the evasions, the blaming, the disavowals of their own actions, the focus on my feelings about accepted practice, the request that I empathise with their position, all having their effect of obscuring their behaviour.
I think it is probably true that sometimes people are disorientated and do not know how to help, but we should not lose sight of the convenience of creating a mutually re-inforced fiction by repeating the mantra “most staff are well intentioned“. If we are looking for comfort, and at times the searing contact with what we as people are capable of doing drives us to need solace, perhaps we should say, “I need to believe that most staff are well intentioned, or I, myself, could not carry on”. If we are looking for progress towards a better possible future, which is to say looking for path that leads us to mutual support, we have to demand something that is more accurate and true, if not subtle. In such circumstances, we might risk making a challenge- we might be brave and state that most staff- like most people, are indifferent. That is, while not actively punitive, they:

  • choose not to see that people are harmed by their actions
  • choose not to see that people are hurting because of difficult life circumstances or events
  • believe that not seeing is the same as not knowing
  • can warp their mind into the belief if you do not know, you do not share in the complicity

If you say “most staff are well intentioned“, check in with what you really mean and expect me to ask you what it is you have glimpsed that horrified you to the extent that you wish you had not uncovered it. What was the void that in spite of all your attempts to reseal the facade, you cannot quite unsee?

Accepting behaviour as ‘well intentioned‘ is not demanding enough, given the nature of the damage that humans are capable of doing. To accede that this is how the world is, is to argue fervently for a fatalisic acceptance that any harm that comes to any of us, in the mental health system or in the wider world, is an inevitable outcome of human limitations. It is an act of submissively concurring with the idea that all of us are alone in a far too dangerous world.

Author: Valid Consent

Promoting trauma informed care

One thought on “Most staff are well-intentioned”

  1. In her 2016 book, The Evil of Banality, Elizabeth Minnich does a very good philosophical analysis of extensive evil, mediated by thoughtless rule following and cliches justification for this. Extensive evil happens every day, in all bureacratised services, with staff blind to its occurrence. I think Minnich’s work casts interesting light on what you’ve written in this blog.

    Liked by 1 person

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