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Attitude: cultivate acceptance and respect

Attitude is key in the healing process. It is impossible to overstress the importance of an accepting attitude on the part of family members. Mental disturbance almost always seems to bring with it crippling self-doubt and low self-esteem. These are all too often reinforced by the stigma encountered in many ways in our society. An attitude of unconditional respect and acceptance, therefore, from those who are closest to the client is the ground from which recovery can begin. This means accepting our relative exactly as he or she is at present. It means seeing all of his or her beauty and strength and good qualities. It means letting go of our expectations that our relative should be any different than he or she is right now.

Looking at the situation solely from the point of view of the medical model makes this extremely difficult, if not impossible, to achieve. For if we view our family member as “sick” and want him or her to “get well”, which implies change, we must think about the message we will be giving. The message will be that our son, for example, is not okay the way he is and must become something different in order to get our acceptance. If we relate to him as if his words and actions have little or no meaning because they are the result of a chemical imbalance, what message are we giving? We are giving the message that he cannot trust his own mind, thoughts and feelings, and that we do not trust them very much either. Though we don’t intend it, these messages come across as critical and disrespectful. This can only reinforce our family member’s very painful feelings of despair, frustration, anger and self-doubt. If these subtle and not so subtle messages are coming from both families and professionals, it becomes much harder for people in these difficult states of mind to trust themselves or others. The ability to trust oneself and important others is a key ingredient in recovery.

How is it possible to give up our dreams and expectations that our family member must have a “normal” life with “normal” achievements? This can be a painful process and take years of being worn down by failures, disappointments and setbacks. It is important to remember, however, that one’s attitude is a matter of choice. One can choose to adopt an attitude of unconditional respect and acceptance – yet to do so requires letting go of most of our cultural conditioning. We are conditioned to see mental illness as pathology and as tragedy. Almost all of the literature and professional opinion describe it this way. Our society’s emphasis on achievement and status reinforce this view. To let go of all this requires a radical shift to a very different way of seeing things. It requires seeing the person as whole and perfect as he or she is. It requires cultivation of a nonjudgmental stance in recognition of our inability to know the whole truth about anything. It requires trust that our experience and the experience of mental illness have meaning, regardless of the outcome. It requires acknowledgement that we are each in charge of our own path in life. It is a point of view that chooses to see the gift hidden in each challenge.

For example, when we talk to our son or daughter, we address their inner quality of humanness rather than their outward appearance or diagnosis. Let us say my daughter exhibits strange or disturbing behavior. My first reaction may be to ask her if she is probably regard it as an accusation and withdraw further into mistrust.

Instead I listen respectfully to what she has to say, with my mind open to appreciate her intentions and to follow her thought processes. I may honestly say that I do not agree with her, or that I find what she says to be impossible. But if I have truly listened, my daughter will trust that I want to understand and that I do not reject her as an adult person. The process of listening itself may serve to open the doors of communication, and may lead to new avenues of thought that will make sense to both of us.

The by-product of mutual respect is that nobody needs to feel under pressure to be anything other than who they are. My daughter will feel free to talk openly to me. She need not feel that she is not acceptable unless she denies her feelings and beliefs. At the same time, I do not need to feel guilt that I have caused some terrible catastrophe. My daughter is not a catastrophe – she is someone I love and respect for who she is.

The unconditional part of respect is the way we value the person behind the symptoms, in spite of the mistakes, and along with the confusion. We do not need to ignore or deny the symptoms, the mistakes and the confusion. Our family member can work on symptoms at his or her own pace, with a sense of relaxation.

Unconditional respect provides a backdrop of hope and acceptance. This attitude of acceptance of our family member is, paradoxically, the attitude on the part of families and caregivers that is most conductive to promoting change. Just as it is a paradox that when we are able to accept ourselves as we are, we are freer to direct energy toward what we might want to change in our lives.

Yet this attitude is a very difficult balance to achieve, because of course we all would like to see our family member happier and having the life he or she desires. The attitude toward our clients we work to cultivate is an attitude of wanting change for them but of not needing them to change. It combines respecting and accepting wherever they are at any given moment – psychotic thinking, altered awareness, difficult behavior and all – with holding out hope and the possibility of change, and at the same time non-attachment to the outcome. This requires humor, patience and a light handed approach rather than a heavy one. A tall order! Yet we have everything to gain and nothing to lose in reaching for it.