In the COVID Vaccine trails boffins at Oxford gathered 40,000 people (80,0000 arms) and split them into two groups.
One would get the vaccine jab and the other a harmless placebo.
The placebo is used in what is know as a “double blind” trial as it provides the gold standard to set the vaccine against. The placebo has a measurable positive effect that is well established in the scientific literature.
This effect is not caused by the material in the placebo jab but from the psychological expectation of a positive change. A great example in the literature is knee operations. It was shown that just going through surgery cutting into the knee and doing nothing reduced patients pain and increased mobility (amazing!)
The Placebo has an evil twin the Nocebo. This is where despite a treatment being benign (chemically and medically) there are negative impacts psychologically which cause measurable side effects like nausea, stomach pains, itching, bloating, depression, sleep problems, loss of appetite, sexual dysfunction and severe low blood pressure.
(An interesting side thought is how would anti-vaxers be impacted by the vaccine given their world view is dead set against it, their mind might cause more damage than the vaccine prevents?)
What does this all mean to social work.
I wonder that given we know as social workers that families are often fearful, sceptical and resistance to intervention or change it is possible that our intervention may cause harmful effects, due to the dread and lack of belief.
Example: A mother who is worrying and not sleeping prior to a social work visit, her body physically and mentally braced for a “punch” from a social work Tyson Fury. Her fight or flight mode (driven by her amygdala) is switched on, her capacity for learning (controlled by her frontal cortex) is switched off, and the body is anxious, inflamed and worn out.
In this scenario the over all impact on the mother health physical and mental may very well be negative, even if the social worker has read every word of Carl Rogers, Community Care magazine and their lecture notes.
How can we beat the NOCEBO. The answer is in its twin the placebo – the power of positivity.
As social workers we have to be the most positive and hopeful person in the room. We have to ‘defrost’ problems and open up a new path for families.
In short, if we don’t feel enthused, or don’t feel confident in the effectiveness of our models’ the families certainly wont. And given their worries about our intervention we may be doing harm. I feel this may be particularly true in cases where there has been repeated failed interventions over the year, as why would you have positive expectations of your 5th Single assessment?
Food for thought.
George Bull
George is a Social Worker at the Connected Carers Team South Tyneside. He has been a social worker for 10 years working mainly in child protection and Early Help. He has lectured with Jamie Scorer at New College Durham, University of Sunderland and University of Northumbria in solution focused practice.
Philosophers forever have contemplated just where the mind is and how the mind relates to both brain and body. Descartes, a French philosopher from the 17th century, was closely associated with an idea called dualism. This idea holds that the mind is non-physical – that it’s situated somewhere other than the brain or body. It’s not a substance – it’s in fact consciousness itself. He called this the mind-body problem. He said that mind can exist outside of the body and that the body cannot think. Mental phenomena are not physical. This gives birth the idea of soul – that there is a part of us that is not physical that exists beyond us
Rupert Sheldrake – a contemporary philosopher and man of faith says that our minds are part of a greater mind – that our minds exist outside of us and are part of something.
He used the analogy of a bucket of water reflecting the moon. The moon is clearly out there but it is also in a sense in the bucket. This is like our minds, he suggests. They are part of us – but they are also in other places. I don’t necessarily agree with this but it’s an interesting idea that has been with us for a long time.
With developments in neuroscience we can very much see that when the mind is active the brain is active. There is a contemporary argument that our mind is made up of nothing other than the physical brain, the chemicals, and the electrical impulses that take place.
Many think that as a consequence of new developments in neuroscience we can’t ignore the fact that many of our emotions and our responses are fuelled by chemical reactions in the brain. Think of nothing more than the fight or flight response that is driven by cortisol and adrenaline. When we’re stressed or scared, we become flooded with those chemicals and we respond to the presence of those chemicals by ‘fighting’ or ‘flighting’. This fuels a response in our sympathetic nervous system. We have another system called the parasympathetic nervous system which also has a little two-word analogy – the ‘rest and digest’ system or sometimes the ‘feed and breed’ system. Because when that system is activated we relax enough to take care of some of the other functions that our bodies needs to undertake in order to remain well. What we know is that if we are in a constant state of stress and if our sympathetic nervous system is dominant then our parasympathetic nervous system doesn’t get a look in. This, in many ways, is the ‘bio’ part of the biopsychosocial model.
I’d argue that as social workers we focus quite a bit on the social part of that model and to a significant extent on the psycho part of it, but we neglect the bio part. Emma Zara O’Brien in her book ‘Psychology, Human Growth and Development for Social Work’ (brilliant book – buy it!) says that the brain is arguably the foundation for, and core of, a person’s future development, behaviours, and experiences. She suggests that not being engaged with neuroscience or the biological underpinnings of human development reduces social workers ability to work alongside and with other professionals.
For many years it was believed that once we reached adulthood the brain was pretty much fixed. We know this now not to be true. The brain has a plasticity – an ability to change and develop. The brain reacts to changes in environment shaped by experience both positive and negative in children and in adults. Harari in his excellent book ‘Sapiens’ talks about this. He talks about our historic animal brain. I can relate this very much to how I see my dog ‘operate’. Essentially primitive brains work in two ways objectively and subjectively. So, my dog knows that if she runs into something it’s hard and it hurts. She knows that the world is full of smells and structures and she knows subjectively how she feels about them. She experiences excitement when she gets treats, she experiences fear if she doesn’t understand something, she experiences delight when having her tummy tickled. She understands the world in these simple objective and subjective ways. One of the problems for our human, developed, brain is that we have the capacity to move beyond objective and subjective understanding to know that there are things out there and feelings inside of us. But those feelings inside of us are still being driven by our primitive brain.
The amygdala the thing driving our fight or flight response is one of the oldest parts of our brain that we have and it’s not clever in the way it deals with things. It’s a one trick pony. It fuels us with adrenaline and cortisol. Humans have developed intellect and create stories about objective things and subjective experiences. We use everything we have to construct ideas of the world.
At birth our brain is 25% of its eventual adult weight. By a child’s second birthday the brain will have grown to 75% of its adult weight. This shows how much development of the brain is going on in the first 2 years of a child’s life as it explores its environment and experiences what’s going on around it. The change is rapid. The child is born with innate reflexes and as the brain develops the child develops ways to take control of these innate reflexes.
Our patterns of communicating are largely shaped by our early experiences from our primary caregivers. The brain needs a stimulating environment. If a child is severely neglected the brain does not develop normally. Sometimes pathways for language can be lost. The brains of children who’ve been denied stimulation can weigh less than the brains of children who have had such stimulation.
At around three years old the hippocampus matures, and this allows the retention of memories to begin – children have few memories before this time. Between the ages of 6 and 13 a growth spurt affects the brain regions concerned with language and spatial relationships. These changes improve thinking and social development and fuel abilities like being able to read, and social abilities like being able to make friends. Early experiences shape the people that we become.
Dr. Sunderland in the 2006 book The Signs of Parenting suggests the following. The developing brain in those crucial first years of childhood is highly vulnerable to stress. Many parenting techniques that are common can upset the delicate balance and stress response systems in the child. This can cause actual cell death in certain brain structures. Quality of life across the life course is dramatically affected by whether or not you established good stress regulating systems in your brain in childhood. One of the amygdala’s main functions is to work out the emotional meaning of everything that you experience. If the amygdala senses that something threatening is happening to you it communicates with another structure called the hypothalamus and this part of the brain actions the release of stress hormones which can prepare your body for fight or flight. Sunderland suggests that if you were left in childhood to manage your own painful feelings on your own your higher brain may not have developed the necessary wiring to be able to perform those wonderful stress managing functions. But all is not lost as the brain is malleable so talking therapies and other life experiences can mitigate against this. But, sadly, some people are left without this opportunity to transform.
The adult brain is fully mature at around 25 years of age. At this age and further into adulthood we have more thoughtful perceptions of the world around us (hopefully!) as the prefrontal cortex is fully developed and we can consider the consequences of our actions through reasoning. A lot of what I’m interested in in terms of self-care has implications here. Exercise promotes the development of brain derived neurotrophic factor. Brain-derived neurotrophic factor (BDNF), is a protein that stimulates the production of new brain cells and strengthens existing ones. When you release BDNF it helps grow brand new brain cells and pathways. High levels of BDNF makes you learn faster and remember better. BDNF also increases your brain’s plasticity – its ability to adapt. When you face stressful situations BDNF protects brain cells and helps them come back stronger. Exercise naturally raises levels of BDNF in your body. Cardiovascular exercise is best and, while a one-off session does no harm, BDNF increases more effectively with regular engagement in exercise. Your hippocampus, often referred to as the brake to your amygdala, shrinks as you get older and BDNF can maintain and even enlarge it.
When you rest (and meditate) you brains Default Mode Network is activated. This is a series of interconnected parts of the brain that get to work once we stop concentrating on external things – once we shift from outward focus to inward focused cognition. Interestingly people who rest effectively have more complex and better connected DMN’s. The complexity of our DMN shapes our capacity for self-awareness. Daniel Goleman says this leads to us being better pilots of our lives, helps us imagine our future, and gives us a greater ability to show empathy.
Our biology then has a significant impact on how, and maybe even ‘who’, we are. This begins to be shaped in our childhood and can continue to be shaped as adults. The impact is a direct consequence of environment, others, and self. We need to attend to all of these things for our personal wellbeing and, as social workers, need an awareness of these connections to help inform people of the potential for change and support people to facilitate such change to become those competent pilots of life.
In order to explore Social Constructionism, I feel we need to take a step back and we’ll do that by having a think about how we know what we know.
Let’s start with positivism. Positivism is a Philosophical position about knowledge – the how we know what we know bit. It’s a belief that it is possible to establish ‘objective truths’ – facts – about things. In social sciences it would be an attempt to apply the same approach as you would to the ‘natural sciences’ and some would argue that that is not possible or even helpful. Positivism would search for concrete causes and causal links.
But maybe it’s not that easy to do such a thing after all nature (things like physics or chemistry for example) is a set of ‘impersonal forces’ but society involves a mixture of forces (e.g. the political, or culture etc). The decisions and actions that people carry out they, in some ways, make for themselves. How human beings interpret a situation is crucial which means there’s no one answer because we all may interpret things differently. Social sciences therefore are concerned with meanings and reasons rather than causes. You might argue that Positivism looks for certainties that are not there.
This takes us to postmodernism. Postmodernism is a school of thought that rejects the notion of objective truths and natural laws and ‘grand theories’ for explaining human behaviour and the world. It is also critical of the idea that developments in science and technology will inevitably lead to improvement (modernism). This is an interesting thing to think of when you have a moment or several! Are we better off as a consequence of the modern world? Alvin Toffler in his 1970 book Futureshock says that we as a human animal are colliding with the incessant change we see and that we are simply not biologically ready for the modern world – needing to be always switched on and always ready to go! Postmodernists feel there is no absolute understanding of society or reality and our sense of reality is shaped through social interactions and processes.
And this leads us to Social Constructionism. Social Constructionism is critical of the positivist approach to knowledge – that everything is knowable as an absolute fact. Our historical and cultural context is important, and knowledge and reality are constructed in our daily interactions and conversations which in turn shapes our knowledge of ‘how to go on’. Different constructions are maintained by patterns of action – ‘practices’ – the way we conduct ourselves in situations for example. There is a construction of lecturer – you expect certain things from me when I’m being one. And there is a construction of student – I expect things from you when you are being one. And others have a view on what ‘student’ is. What if my view and your view and their view are all different? Because they might be. I think you’re a vessel to be filled with knowledge. You think you’re a customer who demands what you need to know to pass the assignment. And others…. Well they could construct you and I in all manner of ways… and they do!
Language describes and defines things and as such has power. Harari in his book Sapiens explains that as the human animal we are the same, as a starting point at least, as other animals. We look at things from a subjective and objective point of view. Objectively we know that things are hard – like if we walk into them – or things are wet – if they are poured over us. We also have a subjective point of view – I’m afraid of heights! It makes me feal fear – and I have a physical reaction to it – my legs turn to jelly.
Harari goes on to say though that unlike animals we tell ourselves stories about things that are imposed on top of these objective and subjective realities. We tell ourselves stories called our family, or our culture, or my job. We tell ourselves stories about what ‘parent’ means or what ‘school’ means, or what ‘student’ means. We have an idea for ourselves sometimes, but that idea is born out of stories we have been told by others – maybe by our cultural position, or through what we have read, or the media. So those stories both describe and define something that will have some similarities with others but will also be nuanced – slightly different – and in some cases, possibly across culture for example, very different. Wetherell and Maybin (in Stevens – Understanding the Self 1996 Sage London) says that this also extends to feelings – quoting Rosaldo (1984) ‘Feelings are not substances to be discovered in our blood, but social practices organized by stories that we both enact and tell”
In terms of this construction of self the person and social context merge because the boundaries of both can’t be easily separated from each other. Psychology, it could be argued, seeks to switch off the social context and the influence of others so that the picture of an individual’s psychological make up is not complicated by such things. Social constructionists say this is simply not doable.
Language is not just a way of describing something that already exists. Words do things as well as having meaning. Language is not a mirror reflecting the objects in our world, but a tool that constructs our world. This brings us to the idea of discourse. Discourse, as defined by Foucault, refers to ways of constituting knowledge that together with the social practices, forms of subjectivity, and power relations, form more than ways of thinking but actually produce meaning.
So, discourse is a systematic ordering of language involving certain rules, terminology and conventions, such as the legal or medical discourse – or indeed social work. Social work has a whole language of its own – Assessment, Care Plan, Safeguarding, Capacity – all things that have very specific meetings within social work discourse and may have other meanings elsewhere. It is a group of statements which provide a language for talking about a particular kind of knowledge about a topic.
Knowledge is flexible, not necessarily concrete, it moves and shifts. The particular ‘common sense’ view of the world prevailing in a culture at any point in time is bound up with power- these are referred to as normalising truths – we normalise or accept as given a particular truth or version of something. Think about the construction of gender or ethnicity over the last 200 years where certain versions were accepted or tolerated by many. This leads to social practices or ‘sites of practice’ that perpetuate that view of the world and marginalise alternatives. It gives us a particular way to look at things that may prove hard to shift because they create opportunities for power that can be used to maintain a position. Powerful ‘knowledges’ keep us in order and get us to control ourselves through the acceptance of the status quo.
So how we construct our reality, the things around us, is influenced by others like family, friends, and colleagues, and by things like media and government. These constructs have a power that is found in them and in the language that describes and defines them.
Social Constructionism recognises ‘the importance of a much more fluid and artistic form of knowledge’. It also suggests that there are complex uncertainties which fits with what we know in social work. How we construct things is fluid and needs to be constantly refined, explored, and challenged I’d argue. Social Constructionism suggests that practices should resist accepted and powerful forms of knowledge.
Social Work is not merely the exercise of ‘technical rationality’. Technical Rationality uses measurements, and empirical research, applies theory, uses instruments and frameworks to collect information, and works towards a ‘truth’ about individual needs. It helps the worker, in the role of expert, generate the ‘right’ answers. As a contrast ‘Practice moral’ offers an interpretation of need based on values, empathy, and experience. It uses reasoning and accepts a variety of perceptions from within the service user’s life (Lishman 2014). It acknowledges that real world problems are ‘messy and indeterminate’ (Parton 2003 p2).
To develop understanding Service users and practitioners should emphasise the centrality of ‘talk’. This forges meanings and relationships. It underpins some key social work ideas like strengths-based approaches (seeing the world the way the service user does to draw on what they bring), and solution focused approaches which seek to achieve the same. A narrative approach helps social workers explore people lives through having them tell their story. The ideas of Social Constructionism suggest that engagement in conversations and interactions, and the patterns of practice these create offers the opportunity to generate new meanings – to become ‘poetic activists’ (Gergen, 1999 p.43 in Parton 2003)
Taking a such an approach from this theoretical position helps practitioners identify the significance of complexity, context, and process and considers where power is at play in those areas. It considers the notion of reflexivity – the ability to examine our own beliefs and practices and adjust them as we go. It emphasises and recognises a range of possibilities for understanding a situation and developing possible responses. It creates a collaborative approach to creating meanings.
There is a sense we are wanting to know ‘how’ rather than knowing ‘that’. We want to know how someone thinks about something rather than simply knowing that they simply think about it in a particular way – a search for meaning and its root, if you like. Such understanding is crucial so that we understand that people are constructing their own version of reality out of their experiences and that they are building and constructing their own world.
References
Burr, V. (2003) Social Constructionism 3rd Ed Sussex: Routledge Gergen, K. (1999) An Invitation to Social Constructionism Sage
Parton, N. (2003 Rethinking Professional Practice: The contributions of Social Constructionism and the Feminist ‘Ethics of Care’ The British Journal of Social Work, Volume 33, Issue 1, 1 January 2003, Pages 1–16
Lishman, J., Yuill, C., Brannan, J. & Gibson, A. (2014 Social Work: An IntroductionLondon: Sage (Paragraph on pg. 66 on Social Interactionism)
O’Brien, E.Z. (2020 Psychology, Human Growth and Development for Social Work(2nd ed.)London: Palgrave Payne, M. (1997) Modern Social Work TheoryLondon: Macmillan
I can’t help but think of this poem when I think about Social Learning Theory because I think it says what it is perfectly…. From the immense poet Philip Larkin – This Be The Verse (That’s the name of the poem – I haven’t just turned into a pirate!!)
They fuck you up, your mum and dad. They may not mean to, but they do. They fill you with the faults they had And add some extra, just for you.
But they were fucked up in their turn By fools in old-style hats and coats, Who half the time were soppy-stern And half at one another’s throats.
Man hands on misery to man. It deepens like a coastal shelf. Get out as early as you can, And don’t have any kids yourself.
Social Learning Theory is a Psychological theory despite the insistence of it having ‘social’ in the title just to confuse everyone! I’m sure you intuitively get how it works from the poem! You may well have picked up traits and ideas, and all manner of things from your parents, your family, your peers… the list goes on. You learn how to go on and what to do from others.
Usually when we talk about this theory, we think of negative things that we pick up from others possibly because the behaviour learnt in Bandura’s famous (and in my view highly dubious in terms of the ethics!) experiment was negative (more later). So, remember we can learn positive things as well! Role modelling… that’s what it is.
The theory is rooted in behaviorism. The fundamental idea of behaviourism is that behaviours that are reinforced will tend to continue, while behaviours that are punished will eventually end – referred to as conditioned responses. We develop learned responses to external stimuli – conditioning.
Social Learning Theory also draws on cognitive psychology because what is also important is what happens after stimulation but before reaction – the thinking bit – the flow of information in your mind before you decide what you are going to do. Our view of the world is self-constructed inside our minds so interpretation of what we observe is also at play. Our brains have a plasticity so although we do learn behaviours, we can modify them – so this is not a fatalistic position. You are not stuck with behaviour you learn but you might decide to stick with it even if it’s not good for you or you might stick with it because you don’t know any other way.
Albert Bandura was an American/Canadian Psychologist working in the early part of the 20th Century on observational learning theory. He observed that conditioning occurs not just from internalising behaviour we are exposed to but from our conscious observation of others.
He suggested that individuals that are observed are called models. These models provide examples of behaviour to observe and imitate so we figure out how to behave from what we see. If someone imitates a model’s behaviour and the consequences are rewarding, then they are likely to continue performing that behaviour. This is reinforcement and can be external or internal and can be positive or negative. For example, if a child wants approval from her parents and such approval is given and reinforces behaviour then such approval is an external reinforcement – it comes from outside herself. But if she is feeling happy about being approved of, and that reinforces her behaviour then that is an internal reinforcement.
If you want to know how Bandura discovered this then this video below will do the job! Save me telling you 😉
Context also plays a role. I suspect you can think of different ways you would act in different places and when with different people. You may well be different when eating out with your parents than you are when you eat out with the boys for a curry. We learn how to behave in different settings – if you want the fancy words around this it’s – cross-situational variability of behaviour. Children are great at it! Those of you who have children know they behave very differently at Grandma’s than they do at home because they know they get away with more and they behave differently at school because they know they get away with nothing – conniving little monkeys!
Bandura says there are four mediational processes at play in Social Learning Theory. These are mental processes that mediate between the stimulus and response. Individuals do not automatically observe the behaviour of a model and imitate it. There is some thought prior to imitation and this consideration is the mediational process. This occurs between observing the behaviour (stimulus) and imitating it or not (response)… so like I said earlier – the thinking bit.
The first is Attention. This is the extent to which we are exposed to, or notice, the behaviour. More exposure or more noticing could lead to more learning. Then Retention. This is how well the behaviour is remembered. Much learning in this way is not immediate. Even if the behaviour is reproduced shortly after seeing it, there needs to be a memory to refer to. We then get to Reproduction. This is the ability to perform the behaviour that the model has just demonstrated. And finally, Motivation – the will to perform the behaviour. Once the behaviour is initiated the rewards and punishment that follow will be considered by the observer. If the perceived rewards outweigh the perceived costs, then the behaviour will be reinforced and will be more likely to be imitated by the observer.
Social Learning Theory may help us understand that people learn behaviour from their immediate environment, not just their past, although it comes from there too. But all is not lost because the brain has a plasticity so behaviour can be modified. If people can learn ineffective ways of being, then they can acquire, through ‘learning’, other ways and so maintain and change behaviour. I feel that social work is one of few professions that always sees the potential of people to change no matter how difficult their circumstances or ingrained and deeply rooted their behaviour is – we need to hang onto that don’t you think?
When we think of power, we usually think of hierarchical power exercised over us by those in certain positions.There is also power in culture. Harari, in his book Sapiens, says cultures have typical beliefs, norms and values but that they are in a constant state of flux and that culture is changed through environment. He says that cultures are simply stories we tell ourselves, stories that we are conversant with. These stories have power because they hold values in them – ways of being, seeing the world, and behaving.
Our social work favourite – Thompson’s PCS model – says that the personal is embedded in the cultural and that cultural is embedded in structural. I’d suggest that this can bring each of these level into conflict with each other in a power struggle for dominance. Think about the white teenager in conflict with the culture norm of their family who are comfortable with racist jokes or cultural norms around the role of women that are in conflict with an ideological view of equality. I wonder is power about who decides what is right? Is there a ‘right’. Or are there many rights? Are people not free to choose their version of right? If they are not where’s the line?
Those who have power or are perceived to have power end up making the decisions…. Don’t they? Sometimes people have a legitimate power that is bestowed on them through position – but sometimes there’s perceived power in the labels that people have – people assume social workers have more power than they often do
Tedam in the Chapter Developing Cultural Competence in Bartoli’s Anti-Racism in Social Work Practice says that culture is difficult to define, it adds to, but doesn’t need to define, someone’s identity – it doesn’t constitute the whole person – but how often do those in power make assumptions it does? It can include ethnicity, religion, beliefs, taboos, language, and history. Ayn Rand, controversial writer in the 60’s who heavily influenced Thatcher and Reagan, says in her essay on racism in The Virtue of Selfishness that history has no business influencing the individual – for her the individual is everything (hence the title of the book). I would tend to agree with this. History has the power to influence culture and culture influences individuals – but we are more than our history. “Glory the past and your future dries up”. says Bono in God Part II on U2’s Rattle and Hum album
Disclaimer! – I’m not suggesting we lose sight of what history has taught us – or indeed that I agree with everything in Rand’s essay – but I do agree that people should be able to shape their own lives and ‘self’ despite their cultural heritage.
Karen Healey in Social Work theories in Context says some things we should be mindful of. She says power is not necessarily repressive. It can be – but it doesn’t have to be. Power can be liberating – ask those who feel they have a lot of it! How power is used, not who has it, shapes the outcome of it. Because… Power is exercised rather than possessed – power isn’t something we have to distribute but rather it is something we exercise over people as a result of position, authority, or because we can because others feel they lack it. When we talk about empowerment, I feel we often talk about it like – as the powerful person – we have it and we can do something that somehow gives the other person some of it. This is not the case.
She says power is analysed as coming from the bottom up. We all can exercise power. But often we don’t realise we can, and if we don’t know we can then we don’t know that we can. We remain disempowered. It’s about showing people how to exercise power rather than thinking we can give them some of ours – that’s not easy and there are all sorts of things that can get in the way. Often how the person views themselves or how the person feels individuals and society views them. Thompson’s PCS model again.
Relating this to social work and drawing on Foucault’s view (also in a Karen Healey book Social Work Practices) Foucault argues that helping professionals play a vital role in providing a bridge between the individual and the efficient management of “men and things”. Societal control if you like, agents of the state maybe? That’s a contested idea but worthy of some consideration. ‘Caring’ interventions he says allow the state to manage and discipline citizens. Think of those with substance misuse problems who can’t get their mental health issues addressed until they are substance free. Such intervention result in a conduit for state control. Power produces a certain kind of population. A one that is subjugated and produces a certain type of ‘self’. Foucault doesn’t deny the existence of structures but says such structures don’t produce ‘local’ power. But rather it is local power – power exerted between individuals – that enables the global phenomena of power.
There are links here then to Autonomy – we need to know we can exercise power to be autonomous – power to control our own destiny if you like. We have autonomy as practitioners and how we use that autonomy is in our hands. But also, how we apply our power, perceived or otherwise, enhances or restricts the power of those we work with.
Davies in Social Work with Adults says autonomy is the right to make your own decisions on personal matters and to be free from interference from the state, noting, however that autonomy is not absolute. We can’t simply do what we want.
He says that where power is exercised through intervention in citizens lives it should be transparent – there should be no hidden agenda – it should be clear what is going on. It should be fair – which begs the question what is fair and who decides what is. Also, rational– what we do should make sense – we should be able to explain it – and it should all stack up. It should be lawful– social work is a profession with a legal framework to adhere to – we need to do that. And finally, it needs to be impartial– this links to being fair I suppose. We shouldn’t disadvantage someone because of our own personal values or opinions. The same should apply for the organisations we are part of. It’s worth considering whether this is the case?
What we do, our actions, should seek to show people the power they can exercise not limit their ability to do so.
The understanding and assessment of risk for social workers is as important as it is challenging.
The current COVID pandemic has brought risk into the public spotlight with social care (and everyone else) facing an array of risk-based judgment calls.
One example from my Connected Carers team is should the children of a 70 year old carer (with underlying conditions) continue to go to school; is it better to harm their education or harm the health of their main carer, what is the probability risk of these outcomes? What is their severity?
Stephen Webb offers a theoretical ladder to climb up with his adoption of the concept of irreducible uncertainty.
This is the acceptance that the risk of a certain outcome will carry with it a level of probability that can’t be assessed, can’t be worked on and that will stubbornly remain regardless of our approach and level of intervention.
“No one can say with certainty whether child abuse will occur, when it will occur (if it does), to what extent it will occur (if it does) or whether it is likely to happen again (if it did occur). Nor is there agreement on the degree of uncertainty involved in child abuse cases. These kinds of uncertainty will remain whatever mode of organisation is undertaken in child protection at a national level” Stephen Webb (Decision making in social work Lecture (2014).
Importantly this unknown element is not in of its self-bad or dangerous it is just a representation of human complexity and the work we do as social workers.
A basic but useful definition would be
Risk = Assessed/measured uncertainty of a future outcome
Irreducible uncertainty = Risk that can’t be measured or quantified
To give another COVID example – we know many risk factors, age, weight, job role, post code, diabetes, racial background. Crucially thou we cannot say with certainty who will get it, who will die if they get, or, inversely, who wont and who will only have mild symptoms.
However, from a risk perspective it is valid to talk about the risk to 90-year olds being a 1 % chance of death and the risk for under 20’s being 1 in 10,000. This immense range is further confused by media reporting the shocking and very sad tiny number of cases of children who have died, it becomes part of our consciousness, so we feel it is more likely than it is.
A social care example would be cases likely Baby P or Victoria Climbe which have led a sea change in child protection. But their story is only representative of an absolutely tiny percentage of all cases open to social care. The point being that considering the most extreme forms of child death and torture are not useful when supporting families that are struggling with parenting, ADHD or poor standards of physical care. Undoubtedly fear of a terrible outcome will always be part of human nature and we have to be aware of this in our practice, to quote her Majesties professor of risk Dr Speigelhalther
“I am as prone to irrational statistical judgements as anybody else”
The messages for practice I feel are,
A risk assessment does not cover all the picture some of which cannot be quantified through social work intervention.
Using extremes as a measuring tool is not useful and can skew practice towards defensive decision making
Whilst we fear the worst-case scenario, we must be aware of how this can alter thinking and allow ourselves as professionals to develop an accurate, case specific judgement, on future outcomes.
George Bull
George is a Social Worker at the Connected Carers Team South Tyneside. He has been a social worker for 10 years working mainly in child protection and Early Help. He has lectured with Jamie Scorer at New College Durham, University of Sunderland and University of Northumbria in solution focused practice.
It sometimes feels like resilience is a dirty word. Whispered in hushed tones in corridors in case over heard. Or spoken out loud as a rallying call to try harder and be stronger. It shouldn’t be this way. Resilience is crucial to a productive life but in social work it is in danger of being shouted down as a take over bid by mangers to make staff do more with less.
The claim I hear most is just that. Managers want to individualise the problem to the social worker, make them be more resilient, and therefore be able to give them more work. I don’t find this to be the case. At worst managers clutch at the straw offered by resilience as a way of keeping their teams well and intact. At best they see it as a real opportunity to develop a confident, satisfied workforce, comfortable with being at work.
Resilience isn’t a silver bullet to fix all of the problems in social work, or indeed to ensure everyone stays well – we all have our point at which resilience gives out. But, by enhancing people’s ability to cope with the rigours of life we do enhance their resilience and they have a better, but maybe not perfect, time of it at home and at work. You can’t separate the two. Stress created at work is carried home and stress created at home is carried to work. We need to embrace the challenge of being resilient everywhere and not artificially separate the two.
It’s about more than emotions. While emotional resilience is important it is underpinned by,and functions alongside, practical and physical resilience. These are what I describe as the three pillars of resilience:
Physical Practical Emotional
And I place them in that order deliberately because that’s how I see them operating.
Physical You must be sleeping well, eating well and being physically active. If you are going to focus on one thing first you must get your sleep right. You can read more HERE and HERE. Then you can work on nutrition and exercise. Without getting sleep right you are unlikely to have the motivation to get these other things on track. The social work office can be a minefield when it comes to eating well and I share some tips HERE. We also can’t overlook the reality of the connection between our gut and our brain MORE HERE. Finally you need to move some, or more, depending on how much you are moving already. Research has shown that regular exercise (in the study it was three 40 minute power walks a week for a year) causes growth in your hippocampus. This is part of your brain that is key in memory, emotional regulation and more. It can be referred to as the brake to your amygdala which is the part of your brain that is largely responsible for your fight or flight response to stress. You can read more HERE
Practical You are not going to be able to fit everything in to your time without being organised. Clinically organised I’d suggest! How you manage your diary, how you allocate your time and how you keep track of all of the things you do is crucial. Have a look through the PRODUCTIVITY section of this web site. Or the BEING ORGANISED section of our sister web site Self Care Shorts.
What you will find in the links above is that all of these things promote our ability to manage our emotional responses to what we are confronted with in all areas of our lives.
Small steps repeated over time lead to big changes.
None of these things in isolation will make a great deal of difference but add lots of small changes together and you will bring down what I refer to as ‘base line’ stress – the stress we carry with is all of the time. The good stress that motivates us. By bringing this level down through implementing strategies in relation to our physical well-being and our productivity we will have more headroom to ride the challenges without hitting our stress ceiling and becoming unwell. Long before we become unwell we become demotivated and prone to procrastination and that simply makes matters worse.
“Control it or it will control you”, as David Allen says.
“Empathy Is Walking A Mile In Somebody Else’s Moccasins. Sympathy Is Being Sorry Their Feet Hurt”. (Rebecca O’Donnell)
The nature of our work as social workers, (or any caring profession for that matter) is dealing with some marginalised sections of society. We do our job because we care. By the very nature of ‘us’ caring, are we being empathic, sympathetic or compassionate? Let’s take a closer look at and see what the difference is.
Empathy Often without realising, we empathise with others in our role as social workers on a daily basis. Meaning we try to understand what our clients or their families are going through from their perspective. We often mentally and emotionally place ourselves in their position as a means of really understanding what things must be like for them. This is empathy.
According to Psychologists there are 3 types of empathy;
Cognitive empathy; the ability to understand someone else’s thoughts, feelings and emotions from a rationale viewpoint rather than an emotional viewpoint.
Emotional empathy; is otherwise referred to as emotional contagion, meaning you ‘catch’ someone else’s feelings, you literally feel what they are feeling.
Compassionate empathy; being able to understand how someone else is feeling and take appropriate action in order to help them.
Sympathy According to Tear and Michalska, (2010), when we perceive, understand and react to the distress or need of another person, this is referred to as sympathy.
The word itself is said to have its origins in Greek ‘Syn’ meaning together and ‘Pathos’ meaning fellow feeling.
Spatial proximital sympathy refers to the level of sympathy we may feel towards someone or something that is geographically closer to us.
Likewise, sympathy for those who we feel are similar to us is called social proximity.
When we become exposed to repetitive situations that trigger our sympathy, we can become less sympathetic and this is what we refer to as compassion fatigue.
Compassion The word compassion stems from ‘Compati’ latin for ‘suffer with’. When we feel compassion, we are moved by the experiences of others so much that we want to take action as a means of assisting or preventing harm. A classic example is making a financial donation to a charity following a natural disaster such as an earthquake.
Compassion is noted as being a virtue, a moral quality that helps underpin how we view the world around us and respond to those within it.
As we mentioned before if we have too much exposure to pain and suffering we can become removed from the emotion of what others are going through.
How does Compassion fatigue affect us as professionals?
Compassion fatigue according to Figley, (2002) was a term first used by Carla Johnson in 1992 when referring to the repeated exposure of trauma by nurses in emergency situations. Figley explains those of us who have a greater ability to empathise with others are more likely to experience secondary trauma. The Professional Quality of Life Scale suggests burnout and secondary traumatic stress are closely linked to compassion fatigue.
Compassion fatigue is a medically recognised condition these days and I can certainly recognise myself as experiencing this in the months leading to my ‘crash and burn’ and career break. I found myself literally feeling ‘nothing’ whilst clients and their families would be sat breaking their hearts in the midst of whatever crisis they were going through.
Reflection Prior to my career break, when I had what I now recognise as compassion fatigue, I often wonder whether not ‘caring’ for the people, actually made me a more effective social work practitioner in a pragmatic sense.
During my cold-hearted days, (I know I’m being hard on myself, but hey I’m reflecting!), as a social worker in adult care, not being emotional enabled me to take a step back from those long standing family disputes. You know the ones where one family member accuses another of something he or she said or did (or didn’t do but should have) 20-30 years ago.
Some families try to involve professionals within their family disputes as a means of having professionals ‘on their side’. I wonder whether being less emotional made me more objective and thereby more able to rationalise information I was gathering, thus placing the service user slap bang in the centre of the assessment process as well as enabling me to stand back from any possible hidden motivations of family.
But what about those of us who are not very empathic? Can we learn to become empathic?
Can We Learn To Be Empathatic? Yes, according to Roman Krznaric, (2015) in his book, Empathy: Why It Matters, and How to Get It. Krznaric, (2010) expands upon five easy steps to expand your empathy;
Cultivate A Curiosity About Strangers, talk to them about their lives, interests and views of the world around them.
Learn From Your Experiences; reflect upon your own experiences of needing empathy directed towards you from someone else and when this did or did not occur. How did it feel? Explore through reflection times when you failed to empathise with someone.
Tackle Your Family Empathy Deficit; sometimes our families are the very ones who fail to be empathic to our needs. Try and put yourself in their shoes and view the world from their perspective.
Take An Imaginative Journey, we know our thoughts can influence our feelings, so in taking ourselves on a mental journey, we develop that part of our imagination whereby we can ‘see’ places in our minds eye. Imagine what someone else is thinking or feeling.
Challenge Your Prejudices; we sometimes make sweeping judgements about groups of people without even realising we are doing so. Notice yourself doing this and stop. Take a step back and take a long pause reflecting upon what someone’s life may be like. What is life like for someone with chronic back pain? What is life like for someone who has mental health issues?
Theory Of Inner Imitation When it comes to social work it is actually suggested that many of us come into the profession having had difficult life experiences. So, in essence we may already be de-sensitised to the trauma of others we end up trying to help (Collins, 2014). With the exception of a few studies over the years that showed males are more empathic than women, Kristen Zaleski et al, (2016) explains women are usually more empathic than men.
Whilst there will no doubt be various reasons for this, which I am not exploring here, Riess, (2010) explores the theory of inner imitation. Riess, (2010) drawing upon the work of Carr et al, (2003) explains how neural relay mechanisms allows those of us who are empathic to unconsciously mimicy postures, mannerisms, and facial expressions of others, (Ibid).
Carr et al, (2003) claims in doing so, the same part of our brains that stimulate motor and sensory areas are activated. An example used by Avenanti et al (2005) is when a patient who has their hand muscle pricked by a needle. The person who is administering, (i.e. the nurse) will also ‘feel’ the needle as the same motor and sensory areas will be activated just by observation.
Conclusion I know I cringe and close my eyes if watching anything gory on casualty on a Saturday night! So, in essence, if our brains share neural circuits in motor, sensory, and emotional areas to help us feel and, in turn, understand what another person is feeling, then possibly this element of our brain functioning decreases if we become burnt out. Riess, (2017) claims this is exactly what happens and as such, we need to become much more aware of how we take care of ourselves as a means of helping us to maintain our levels of empathy.
For me in our role as social workers, I see empathy as being a major requirement to allow us to really get into the heart of people’s lives – those who we are trying to help. But I also recognise how in the past this has led to my own struggles with mental wellbeing and professional burn out just by trying to help others.
Its these very experiences that we try and bring to your attention, so you can learn from them and in turn hopefully, promote your own physical, mental, emotional and spiritual wellbeing.
Avenanti, A., Bueti, D., Galati, G. and Aglioti, S.M. (2005) Transcranial Magnetic Stimulation Highlights The Sensorimotor Side Of Empathy For Pain in National Neuroscience, 2005 Jul; 8(7):955-60.
Carr, L., Lacoboni, M., Dubeau, M.C., Mazziotta, J.C. and Lenzi, G.L. (2003) Neural Mechanisms Of Empathy In Humans: A Relay From Neural Systems For Imitation To Limbic Areas in Proceedings of the National Academy of Sciences of the United States of America, 2003 Apr 29; 100(9):5497-502.
Tear, J., and Michalska, KJ (2010). “Neurodevelopmental Changes In The Circuits Underlying Empathy And Sympathy From Childhood To Adulthood”. Developmental Science. 13 (6): 886–899
Was Shylock in Shakespeare’s Merchant of Venice making a critical decision that was necessary and proportionate, when he was demanding his pound of flesh?
Let me give you a brief rundown on how Shylock found himself in a position where he was able to demand a pound of flesh from the poor Antonio.
Shakespeare sets out his stall telling us how Bassanio wants money so he can impress his bride to be Portia (we will meet Portia later). Bassanio asks his friend Antonio to lend him the money, however all of his friend’s cash is invested in merchant ships. When his ships come in he will have a canny penny (that’s my Geordie twang not Shakespearian English!) and be able to lend Antonio the cash to impress Portia. Bassanio decides to lend money from Shylock for Antonio. Shylock sets up a contract with Antonio which states that if Antonio does not honour his debt, he will forfeit a pound of his flesh. A bit extreme however I doubt Shakespeare writings would have been so successful if the forfeit was he had to shave of his hair!!
Surprise of surprises he is told that the ships have sank. Antonio is unable to pay his dept to Shylock and Shylock has him arrested and takes him to court demanding his forfeit. Antonio’s friend offers to pay double his debt, however Shylock demands the forfeit to be met.
This sets everything up for a dramatic court room scene more dramatic than Judge Rinder. Let’s look at where Shylock may be, with his thinking. Shylock is Jewish and tells us of the discrimination he faces in his brilliant heart felt stanza
To bait fish withal;
if it will feed nothing else, it will feed my revenge.
He hath disgraced me, and hindered me half a million,
laughed at my losses, mocked at my gains,
scorned my nation,
thwarted my bargains,
cooled my friends,
heated mine enemies –
and what’s his reason? I am a Jew.
Hath not a Jew eyes?
Hath not a Jew hands, organs, dimensions, senses, affections, passions?
Fed with the same food,
hurt with the same weapons,
subject to the same diseases,
healed by the same means,
warmed and cooled by the same winter and summer as a Christian is?
If you prick us, do we not bleed?
If you tickle us, do we not laugh?
If you poison us, do we not die?
And if you wrong us, shall we not revenge?
If we are like you in the rest, we will resemble you in that.
If a Jew wrong a Christian, what is his humility? Revenge.
If a Christian wrong a Jew, what should his sufferance be by Christian example?
Why, revenge!
The villainy you teach me,
I will execute, and it shall go hard but I will better the instruction.
What we also learn is that Shylocks daughter has married a Christian and converted to Christianity. Shylock appears to be using his contract to seek justice and revenge for the racism he has been clearly subjected too, and with his daughter choosing to convert to Christianity he clearly feels that he has is justified to seek his revenge by demanding his pound of flesh.
So lets put this into some social work content, The Liberty Protection Safeguards have replaced DoLS and if as social workers we are planning on depriving a person of their liberty we now have a legal duty to ensure that the proposed deprivation is necessary and proportionate and this needs to be evidenced. Shylock is proposing a course of action by taking a pound of flesh from a person and we can understand his reasons for vengeance. He has clearly been a victim of racism and he has been treated horribly. Antonio entered into his contract willingly so should forsake his pound of flesh?
If we are planning to deprive a person of their liberty I do not think it is too much of a stretch to say the magnitude of a decision to place a person into care potentially against their will can be as dramatic and serious as Shylock’s decision to exercise his right to uphold Antonio to his contract.
Let’s apply the necessary and proportionate test to Shylocks decision to take a pound of flesh from Antonio. Firstly, is it necessary to? Questionably there is a legal contract that all parties willingly signed up to. Although we as readers would seriously question the necessity of placing a pound of our flesh as collateral to a financial loan. Now, like most, I am not a rich man and I have needed to rely on bank loans and overdrafts throughout my adult life, however I have never read the small print in the terms and conditions. I however do hope that a pound of my flesh was not used as collateral against any loan!
Was it necessary for Antonio to enter the loan, I would have said no. Let’s apply some critical thinking to this, clearly something that is lacking from the love struck Bassionio. What Antonio failed to recognise was that his thinking was heavily influenced by the matters of his friends heart, which blinded him into considering the risks into entering into this contact. If he had applied critical thinking, he would have calculated what the facts of the transactions were. Was the risk worth taking? Did he need to enter into the contract, and more critically how were his emotions impacting on his decision-making ability. How much was his desire to support his friend to marry Portia blinding his ability to critically evaluate the contract. And for our poor Shylock he is clearly influenced by the prejudice he has received, not to mention his perceptions of his abandonment from his daughter. Did he critically evaluate, ‘I have years of pent of vengeance brewing in my thoughts, so I need to be careful not to allow those into thinking when drawing up his contract’. I suspect not.
So, we can establish that the lack of critical thinking from all parties has resulted in a great difficulty in establishing if honouring the contract was necessary and proportionate. The legality of the contract was not in doubt here, however, if they did apply critical thinking at the time of drawing up the contract, we could seriously argue that the contract was not necessary and proportionate.
Firstly, he wanted the money for his friend who did not really need it. So, his loans were not necessary. Secondly, giving up his pound of flesh and potentially his life was not proportionate to him having extra cash for Bassiono to impress the lovely Portia.
Was the contract necessary and proportionate for poor Shylock? The short answer is no. He was hell bent on seeking his revenge and his revenge is something we can understand. It would appear this man was persecuted and subjected to horrendous racism, which resulted in him wanting his pound of flesh. Spoiler alert this became his downfall. If he had approached this contract and was aware of his own feelings and desires for justice, he could have reflected through this and applied a more sensible and less dramatic penalty for non-payment of debt.
So legally the pound of flesh is necessary as that was the terms of the contract, however is it proportionate? Again, although we would say that a pound of our flesh is not worth any financial gain, especially if we live in a time without anaesthetic and the removal of a pound of flesh would have a significant risk to life.
Let’s once again apply ‘necessary and proportionate’ to assessments in social work and in this context we are talking about a ‘contract’ which will deprive a person of their liberty. In order to avoid making emotional decisions as did Shylock and Antonio the social worker needs to navigate their way through emotions that could be just as powerful as Shylock and Antonio’s, such as family members strong opinion that there relative would be safer in care. This can be a powerful motivator and their views should and do influence the decision of the social worker, however, heed the warning from Shakespeare here. A family member who wants to place their relative into care, may have very emotive reasons for their decisions such as they believe it is the safest option for the person. Take a moment to think about that, if you believe that one of your loved ones is not safe and their life is at risk and you firmly believe that they would be safer in a care home your views and opinions will be very set and vigorous. They may believe the person cannot make the decision themselves and they may become angry at social services as they believe social services are more concerned about not making payments for residential care. It’s up to the social worker to critically analyse all the available data. This is not easy as not only is it right to gain the views of loved ones, there is also a legal obligation to do so if the person lacks capacity to make that decision themselves under the Mental Capacity Act. So how do we apply critical thinking here that would lead us to be able to apply a professional ‘necessary and proportionate’ assessment.
Firstly, the facts need to be established. What happened? When did it happen? What were the contributing factors? Secondly those facts need to be robustly questioned and picked apart to explore where is, and how we can gain, evidence. We then need to consider the persons views when we relay those facts to them as well as the options of their loved ones. So, at this point we have applied critical thinking and we have been able to establish opinions from facts. The social worker then needs to evaluate the evidence of the options available to the person, i.e. the risks and benefits associated with living in residential care, such as risks associated with living with others who are experiencing difficulties, risk of abuse, risk of falls, and risks associated with loosing your home and potential liberty. Once all this data has been critically collated it needs to be given in an unbiased way to the person that needs to make the decision. Which of course is not the family member but the person themselves.
If the person is not able to make a decision through lack of capacity, which needs to be established via a mental capacity assessment. Then the social worker, providing there is no lasting power of attorney, needs to make a best interest decision and a subsequent necessary and proportionate assessment. First of all the social worker needs to establish if the deprivation is proportionate to the needs of the person and if it is proportionate, could these needs be met in a less restrictive way? Providing that due process has been carried out and the evidence has been critically evaluated then the assessment should not be too onerous.
If critical thinking has not been applied this area could be fraught as Shylocks and Antonio’s was and you could reach this stage in decision making with opinions and facts not appropriately established. What the social worker needs to be aware of is why the family member has their opinion, what the views are of the actual person and weigh these up against the evidence by carefully establishing what are facts and possible outcomes are. The danger with such emotive decisions is that the emotion takes over the critical thinking and a decision is made on a person’s liberty based on fear and not on evidence. The social worker needs also to reflect on what they are bringing to the table and what are their fears? What are there past experiences and how do they influence their ability to make a decision?
So what happened to poor Shylock? Unfortunately for him someone was applying some critical thinking and cast a critical eye over the contract and asked him to honour his contract and ensure he produced a pound of flesh only. He could not take any more or any less and not spill a drop of blood. If he did not honour the contract in such a specific way his life would be forfeit, subsequently he could not do this as he would spill blood which was not in the contract. The process of taking his pound of flesh would result in the death of the defendant which was illegal in Venice and resulted in charges against Shylock. He was ordered to be a Christian!!! (I’m not sure how you can enforce that one) and share half of his wealth to Antonio and the other half to the state. His lack of critical thinking when drawing up the contract has truly bit him on his backside. Antonio had a somewhat happier ending and his ships had not sank and they had actually come in. Hurrah!
Such a tragedy for poor Shylock and a turn of luck for Antonio. And there lies the risk that is taken here, such important decisions that are made on the back of human emotions and not on critical thinking can lead to absolute disaster or triumph, and this is not the approach we should be taking when considering a depriving someone of their liberty. As the reality is, a wrong decision can contribute to a premature death of a person and the consequences could be far greater than those which Shylock was made to endure. Or they could result in a positive change in someone’s live, or more probable somewhere in between. What Shakespeare has showed us in his play The Merchant of Venice is it is the critical thinker that reduces the chance of an unhappy ending. As in this case the Doctor in Law was none other than Portia in disguise supporting Antonio. The fact that she committed fraud and claimed to be a Doctor in Law and a man seemed to go unnoticed by Shylock.
The key message here is to ensure that as a social worker you critically evaluate the information you have gathered and have sought evidence when it is required.
George Bull, Social Worker at the Connected Carers Team South Tyneside, explores Dr. Dan Siegal’s hand model of the brain and its use in social work practice.
In the Solution Focussed Therapy model of social work practice the core goal is to nurture the innate self-capacity for change and repair in individuals and families. I strongly believe unless this is achieved the people we support are vulnerable to our repeat involvement as they perceive that their problems (which often perhaps inevitably recur in some way) can only be solved alongside the practitioner.
I’ll give you an analogy. Think of a car owner who does not know how to change a windscreen wiper blade. They will either struggle on with a wiper blade that leaves the screen murky or go to a garage and professionals will entirely repair and replace the wiper blade. They will do this for every car they own. The other option is that at some point the car owner tries themselves to change the blade or is shown how to do it by another car owner who knows how to do it. They can then do it themselves forever!
The DIY job we seek to do as social workers is supporting people to change the patterns of behaviour that have led to the issue becoming fixed and other wise immovable. Quite simply patterns of behaviour are cemented by the human brain that seeks to develop the best strategy available for survival. The optimal option being to seek to replay past successful strategies over and over.
A previously traumatized child or adult’s brain will recognize that it survived the traumatic experience and that the behaviours of shutting down, running away, or fighting worked. Survival is so paramount the brain cares not if the lifestyle and relationships for the person are severely impaired due to this strategy.
How can this hard-wiring be addressed?
Daniel Siegel the author of Mind Sight and the Child Brian has developed a simple and massively accessible model to support this “The Hand Brian Model”. (video at the bottom of the article)
This model offers social workers a very tactile and easy way to demonstrate to children and adults why and how their brain is responding with negative automatic behaviours like hitting out, shutting down, and addiction.
Siegal explains that the two competing areas are the downstairs (limbic system) and the upstairs (frontal cortex). By explaining this to an individual the social worker has lifted the bonnet of the car and is letting the person look beneath it perhaps for the first time. This is the opposite of dumbing down. This is explaining neuroscience to children and adults to increase their understanding of their own bodies and behaviours.
This specific point of looking under the bonnet or inside their brain is where a small important change can happen, looking at your behaviours from the lens of being one step removed creates a transformative perspective namely meta cognition which is highly linked to healthy attachment and positive mental health and lifestyle.
The key point to stress is that limbic system fires first automatically and leads the person to damaging behaviours that will continue the issues they are struggling with. This is represented in the model by the thumb (see the video below). Only by slowing down and engaging the fingers, which represent the frontal cortex, by wrapping them around the thumb, can this powerful part of the brain be challenged and potential for change created.
By demonstrating the functions of the brain and by the using the body an instant and memorable connection is made increasing the chances of the model being used again after the session. Just like a joke or an anecdote it is immediately accessible, social and totally memorable.
This I feel sets this model apart from many others I have seen. Children and carers remember and continue to use this over extended periods, and indeed explain and teach others about the model.
Social care professionals rarely use any brain science in their work as they feel they are not expert enough. By keeping it simple and being confident in the basics social workers should aim to build this knowledge with children and families. After all its about their brains.
So, give it a try watch the video, put the model in your practice locker and I bet in the next few weeks of practice the opportunity will arise where it will be relevant. At this point just remember don’t be like the garage! Do better by building knowledge, building capacity and revealing what is going on under the bonnet.
George Bull
George is Social Worker at the Connected Carers Team South Tyneside. He has been a social worker for 10 years working mainly in child protection and Early Help. He has lectured with Jamie Scorer at New College Durham, University of Sunderland and University of Northumbria in solution focused practice.
