This is a concept we talk a lot about at school. It is part of the commitment we make to doing this work,treating our clients with unconditional positive regard. For me this, like so many aspects of social work, goes beyond my clients. It is a goal to strive for in life, treating others with unconditional positive regard. I’ll let you in on a secret though, it is not possible. It is not possible to treat every single person you meet and interact with in life with unconditional positive regard, not without completely abandoning yourself, and then you would not have succeeded anyway because unconditional positive regard starts inside.
So we start with our clients and then try to extend that concept out into the world as far as we can understanding that sometimes we feel other ways about people which is okay, that is when we make sure to turn unconditional positive regard inward to take care of ourselves in that moment.
I was thinking about unconditional positive regard on my drive home today because of a conversation myself and a fellow intern had during a break.
Today was a day for deep conversations in the intern office. Next week we start taking on our own cases so today was a lot about prepping. We cleaned the office and organized it the way we wanted. We went through all the different work books and tagged the worksheets we will want to use with clients, we did a few more trainings on the computer, and in between we chatted. We talked about religion and spirituality, turns out this intern and myself share a common thread in that we were both raised in Catholicism and walked away from it as soon as we were confirmed. We talked about some of classes. We talked about the importance of doing your own work (through therapy or in other ways) in order to be an effective clinician. We also talked about some of our fears, specifically as they pertain to certain populations.
In school we are taught that you have to be open to all different populations, different spiritual backgrounds, genders, sexual orientations, ages, cultures, races, etc.. For some people this idea is difficult for them from the very beginning, others do not think it will be a problem for them at all (me using my “I” voice I kind of wonder how honest they are being with themselves), many fall somewhere in the middle. I am one of the ones who falls somewhere in the middle.
What got my colleague and I on the topic of this particular fear/concern is a story I was sharing with her about a podcast I was listening to over the summer. Trigger warning I am going to talk about pedophilia on a superficial level.
I was listening to a podcast wherein someone who self-identified as a pedophile who had never acted on his thoughts shared his difficulty when seeking out a therapist to help him with his condition. He was young, maybe 20, and he had been having these thought since around the time he started high school if I remember correctly. He talked about the shame he felt, and he knew it was wrong but that he did not feel like he could control the thoughts. Not too long after it started (the thoughts) he went to his mother and told her that he needed to meet with a therapist, he did not disclose why just that it was very important. His mother scheduled him to meet with a therapist. Upon the initial meeting and after listening to his story and why he was seeking out help the therapist quickly told him that they would not be able to help him but they would refer him to a therapist that could. The therapist also told the client’s mother without his permission which I understood and at the same time my heart ached for the client because this deeply impacted their relationship. His story went on to tell how therapist after therapist turned him away, I am sorry I cannot help. Referral after referral was made, help started seem further and further out of reach. Feelings of shame and isolation grew, not even those trained to help could help him, who could?
I am sorry to say I do not remember how this story ended. I do not remember if he ever found the help he needed, I hope he did.
After sharing this story my colleague and I talked more about whether or not we felt this client would have been a problem for us. Would we have helped or referred him on? We then talked about other populations that are severely stigmatized and where we stand in those cases.
Then we talked about compassion. This is where the unconditional positive regard comes in. When we think about pedophilia a clear line is drawn between victim and perpetrator. One is shown sympathy, the other is demonized. I am NOT at all in any way trying to downplay or dismiss the experience of the victim in these situations, we (my colleague and I) did agree that there was still compassion to be had for this person who shared his story and others like him though.
There is compassion to be had with all people. What I was thinking about specifically on my car ride home is how society creates stigma through fear; and what I may be doing in my own life to further stigmatize those already facing severe stigma and shame. What it came back to for me is something I say a lot and that is words matter.
Last summer I stopped using the word crazy as a filler word in casual conversation. Now instead of saying we are having crazy weather I say what I actually mean, it sure has been raining a lot. Crazy is a loaded word for a lot of people, myself included, it may be should not thrown around so casually without thought about impact to others. Another good example is replacing committed suicide with died from suicide. Committed has a negative criminal connotation that stigmatizes the bereaved. I took a training on this in the spring and have since been mindful of this.
One that really stuck out for me on my drive though was the term narcissism. If you go far enough back in this blog you will find I am guilty of throwing that word around casually with deliberate intent to judge others. Typically I would be using it to refer to society’s social media habits. Here is the thing though, this is a diagnosis that is already SUPER stigmatized, it carries a lot of weight. What does it say about me as a future clinician and my commitment to unconditional positive regard when I do this? Individuals who are on that spectrum are worthy of compassion and unconditional positive regard as well.
We are all capable of causing pain and harm, we are all also worthy of compassion. I am willing to bet that there will be times over the course of my career where I struggle with a specific client for one reason or another. I may even have to refer a client to another clinician. I will always be mindful of my commitment to unconditional positive regard though and mindful of what it means to practice it both professionally and as a human being.