I have been thinking about writing some essays about key concepts in mental health nursing, maybe with the idea of publishing something. Here's something I wrote about the therapeutic relationship a while back. I really like how I was able to describe what is often times so difficult for me to put into words. While this is a core concept in mental health nursing, I believe that nurses in any area need to recognize that we may not be able to accomplish much alone.
That's enough of an introduction.
A few years ago one of my students wrote about her experiences with people with mental illness. She wrote about someone close to her who was struggling with depression:
She could not escape from telling herself horrible things in her mind like “You’re not good enough, you’re never good enough,” “You’re so ugly, who could love you?” “You brought all this down on yourself by not being the wife he wanted you to be” – just awful things that were not true! Her mentality was breaking her and holding her down. But she could not conquer the thoughts.
All through school I was always the friend that tried to fix everyone’s problems. I was good at it. I always had the “mature” answer, apparently. I have tried to give people my opinion but also offer them tools that have proven successful for me in order to allow them to solve problems themselves. But I cannot always save people from doom. I have to let that go sometimes. People, just like me, have to learn lessons on their own. I need to listen more and talk less.
I circled three sentences on her paper (underlined above) and wrote the following comments to her:
Both the “could not escape” and “could not conquer” comments paint a grim picture of almost inevitable despair as a result of mental illness. Note also the last comment that I circled. You (we, anyone) cannot always save people…another grim picture.
Yet I firmly believe that there is hope. Even though we cannot always “save” people, we CAN help them. We CAN interrupt the slide into madness and despair as moods shift or thoughts torment. We can brighten a minute or an hour of a bleak day. A person may not be able to “escape” or “conquer” illness alone. We may not be able to save anyone alone. But we can accomplish things by working TOGETHER. This is the power of the therapeutic relationship. Neither the client nor the nurse may be capable of achieving much by working alone, but a partnership between client and nurse gives both of them the chance to make a difference.
