I am delighted to see that Wellness, Self-Care, Self-Management are the current buzzwords for health and recovery right now.
It was a long time coming but its good to see an acknowledgement that it is the individual who knows their life best and, in that, knows what doesn’t work for them and what might work a little. Some people, read “self-care” as “self-directed” as if it was a solitary model for implementation by the client, remotely, all on their own. Not so, of course – we, as individuals, need some direction towards self-care but it is in the detail of that “direction” that leads towards successful self-care.
Anyone who has worked in the Social Care and Health sectors for any amount of time will have experience of working with individuals who do not respond to the “tell and explain” and “warn and cajole” ethos that has always been the primary approach, especially with patients. Much better, we have always found, to ask “How will you manage this condition?” than to give strategies that might not fit with them at all.
When working with individuals who have low level anxiety or depression for instance – asking about “exceptions”, times when they overcome it or managed the condition better, is crucial in instigating an acknowledgement that there are moments, at least, when they do manage and it is the professional’s role to be curious, in detail, about that time – “how come?”, “what are you doing differently at that time?”.
A “discovery journey” of the small successful details of our lives that we can harness in the work towards recovery, is the very first step of self-care.
A person presenting with a problem has historically been met with a diagnosis and a treatment plann – a treatment plan that is often a generic one that others will also receive, i.e. “you need to do x,y and z three times weekly; eat more of; less of; do more of..” This approach makes it very easy for the individual to resist the instructions if its doesn’t fit with way they live their life.
GP’s that we have trained in our “Working towards Recovery” programme, have directed their patients thus: “So, the diagnosis is……. and the body needs x, y and z …. how will you approach this in your day-to-day life? ”
Questions that lead to self-examination of the minutiae of our lives and what will fit with our lives and a preparation for its implemention are the foundations for self-care and is the opposite of the passive receiving of instruction, which can then be ignored once the patient is back on home ground. It is so easy consciously and subconsciously to ignore the professional’s instruction: “you must take exercise regularly” or “I want you to cut down on x,y and z”. Asking pertinent questions about “what will work at home?” and “how will you achieve these recommendations in practice ?”encourages the individual to connect with the unique structure of their lives (because the Doctor is waiting for an answer….) and replies to the same question by a dozen clients will be totally different: i.e.
“I will walk to work and get the bus back”
“I will eat x instead of y”
“I will use the stairs instead of the lift in my flats”
All of these responses are unique to that individual and are therefore more likely to be owned by the individual. The professional, focusing on the minutiae of the patient’s life, can be even more curious (and therefore making the patient’s plan more concrete) i.e.
“What time will you be doing this every day?”
“What foods will you enjoy instead ?”
Our wider Diabetes Sweet Spot Programme, devised in collaboration with our partners in the USA, Riva Greenberg and Bou Bertsch, Diabetes and Leadership Experts respectively – includes the culmination of the session with the Doctor then scribbling the Patient’s final plan on his/her pad and, in the manner that we have come to expect since childhood, tearing off the sheet and handing it to the Patient “Ok, I am very interested in how you achieve this, perhaps you would observe how useful your strategies are and come back and see me in 7 days with an update on your progress” To emphasise how important this element is, we include the actual pad for the GP to write on!
We are running a one day event on 28th February 2013 in London, It’s What’s Right With You That Will Fix What’s Wrong With You covering the whole framework of working collaboratively with individuals to ensure better self-care and self-management in real and practical ways, including Mindfulness with a workshop from best-selling author, Dr Danny Penman, author of Mindfulness – Finding Peace In A Frantic World. In the meantime, if you have questions about either our main Working Towards Recovery programme or our international Diabetes Sweetspot Programe then do please contact us on firstname.lastname@example.org