http://mg29.ru/dast/gokycyv.html In Part One of this blog I gave an introduction to Nonviolent communication (NVC). In this second part I look at how I've found it helpful in mental health settings...
http://www.tiwaz.nichost.ru/prioriti/bujydakig.html As I outlined in Part One of this blog, NVC is an empathy tool that gets us to focus on our own and other people's feelings and needs. However the dominant way of relating in our society is to ignore what we feel and need and focus outwardly on what systems need. Where we don't fit in to society's expectations we are taught to judge and blame ourselves and each other. Marshall Rosenberg calls this judgemental way of relating "jackal language" and empathic ways of understanding "giraffe language." He and other NVC proponents have used giraffe and jackal puppets to convey the ideas in NVC (see Note 1 below). Here are some examples of Jackal talk (some of which, I've used myself in the last couple of days):
- “You're getting on my nerves.”
- “He's a control freak.”
- “I am an idiot.”
- “They are obsessed with themselves.”
These are all examples of judgmental thinking. We say what we think is wrong with the other person or ourselves, and a sense of blame is often attached. If we use NVC (or Giraffe language) to look empathically at the statement “You're getting on my nerves,” it could be translated as: “I am really tired and vulnerable right now and need to take some time out to look after myself.”
Jackal language might initially seem like it protects us and at times can get others to do what we want, but it tends to damage the relationship we have with that person. So if I shout at one of my sons:
- “Stop being so slovenly and tidy your bloody room!”
He may tidy his room, but out of fear of more judgement rather than out of a need to live cooperatively. As a result our relationship will be likely to deteriorate.
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We live in a society that is largely built on domineering ways of relating. This privileges the needs of systems and those with status and power. However, partnership ways of relating based on equality and empathy have always also been present and seem to be growing. Whilst domineering practices are still strong, gradually 'power with' as opposed to 'power over' ways of relating are being used more in different parts of society — including education, business and the family home (see Humanzing Healthcare by Melanie Sears, 2010).
Systems that privilege domineering relationships involve everyone in the system being socialised to suppress or deny their true feelings and needs. People in power have to ignore their own need for connection and empathy from others. Those complying with domineering practices have to ignore their own will and the wisdom that comes from an awareness of ones own qualities and needs. Domineering ways of relating are strong in the mental health system. Health systems are extremely hierarchical and, rather than empathy, the dominant approach to people's difficulties is based on top-down management practices, which assume experts know what is best for people. When we learn to ignore our own wisdom a culture of dependence is created, where we think we always need other people (or pills) to solve our problems.
I am hopeful that we can help people within the mental health system and other parts of society to strengthen their empathic ways of relating. Within self-help groups I have helped organise we have tried to approach everyone as having wisdom and expertise, and to share empathic ways of relating. However, I've noticed how easy it is for me to get feel quite righteous and do my fair share of jackal talking about mental health workers who seem more judgemental in their approach. Jackaling the jackal however is probably not the way forward. I realise that if I really want to help change things for the better I will also need to use NVC to understand people who seem to be my opponents.
I have used NVC to help people recognise they have legitimate feelings and needs. For example, I worked with a man who blamed himself for being bullied as a child. When we used an inventory of feelings and needs (see Part One) he was able to identify feelings of sadness and grief related to the fact that he did not get the respect, consideration and understanding he needed from his fellow pupils and teacher. I see NVC as one way to learn to be more compassionate to ourselves.
I employ NVC to give myself empathy, as well. After a demanding working day I can easily ignore my feelings and distract myself by going on the internet or reaching for the cake tin! However if I tune into how I am feeling I might notice I am feeling overwhelmed and sad and deduce that I need some relaxation time or perhaps to go for a walk in the woods near where I live. Being honest with my partner about how I am feeling helps me get the space I need to take care of myself, or some supportive conversations and a hug!
NVC (describing the facts, feelings, needs and making a request) has given people I know using mental health services, a good structure to give mental health workers feed-back about what they feel and need. Iam not saying its a panacea that solves all conflicts but I have seen it be very helpful in increasing understanding. Melanie Sears in her book - Humanizing Health Care: Creating Cultures of Compassion With Nonviolent Communication - describes projects where forensic hospital units have invested in training in NVC for staff and patients and howas a result coercive procedures and violent incidents were reduced significantly.
I believe there are times to collectively challenge psychiatric practice and lobby for alternative approaches. I try to invest my time in both creating alternative spaces for people experiencing intense confusion or distress and working within the established mental health systems. At times working in the mental health system as a psychologist I have also found it practical to empathise with those in positions of power in order to negotiate new ways forward. When we empathise with someone's aggression or obstructive behaviour it does not mean we agree with it or support it. We are going behind the difficult behaviour to trying to understand the needs underlying it.
For example if a psychiatrist refuses to reduce somebody's medication when they ask for a reduction, we can focus on analysing and judging the psychiatrist for being controlling, risk averse and ignorant. Alternatively, I've found it helpful to use NVC to try and think about the psychiatrist's feelings and needs. Maybe they are anxious about change and worried if the person becomes more agitated on less medication and does something destructive, they will be blamed. Knowing this is a possibility, I have sometimes been able to reassure the psychiatrist in this kind of situation, that there are a group of people willing to share responsability for supporting the person to be on less medication - so that if things get difficult they will not be blamed.
Having these kinds of understandings has helped me in my negotiations with people in power. I've also found that empathy skills can be useful to avoid feeling constantly angry with people who don't adhere to my world view.
I do think it's good to let ourselves be judgemental sometimes and release that part of us that enjoys confrontation. I have found I need to do it carefully at the right time and place (for example, in humourous exchanges ). I also think there is a time to be angry and channel our feelings of hurt into actions that protect us, or to stand up for more fair and compassionate ways of relating. However endlessly using jackal or blaming talk about people who see things differently will backfire and not produce the kind of respectful relating we desire.
I do think there's definitely a place for the jackal. Once I was camping at a festival where I had run an NVC workshop. The next day, early in the morning, someone started banging a drum. I started to think what I would say using NVC. Then, before I had formulated 1) the facts, 2)what I was feeling and 3)needing and 4) what request I was going to make — someone else intervened, saying:
- “Its Five O'clock in the morning, shut the **** up!"
In this situation a more direct form of communication seemed very effective. The drumming stopped immediately.
Note 1. A lot of people appreciate the jackal and giraffe puppets as a playful way of conveying the ideas in NVC but like most things not everyone likes the puppets, some have told me they find it patronising or it reminds them to much of the aggression of Punch and Judy puppet shows.
Thanks to Elisabeth Svanholmer for editorial advice.
Humanizing Health Care: Creating Cultures of Compassion With Nonviolent Communication by Meanie Sears (2010), PuddleDancer press
How I've found Nonviolent communication helpful, Part One
Raamro Aakha Ma (In the Eyes of the Good): New film by Carolyn Davies about using NVC to help with reconciliation processes in Nepal
Compassionate Communication Skills in Mental Health Settings: Forthcoming training on using NVC in mental health settings