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Love based Mental Health Care
Love based mental health service - What do I mean by that?
There are many types of love in the world. CS Lewis suggested 4 types:
- Storge (PHONETICS) - liking someone through fondness or familiarity
- Philia - the love shared between friends
- Eros - romantic love including sexual love
- Agape - unconditional love, a love that is projected outward and is given regardless of circumstances.
In order for intimate relationships to thrive all of these types of love are necessary. In mental healthcare we don't have relationships right? Wrong. We are engaging in relationships all the time in healthcare. OK they are not intimate relationships in the traditional sense but they are still relationships. Research shows us consistently that it is the relationship that exists between two people, in a counselling encounter for example, that really makes the difference and helps people to learn to overcome difficulty and flourish again. Patients of MH services who have a care coordinator have a relationship with the professional; within a patient/GP encounter we create a short term relationship in order to share a trouble and ask for help. So you see that in health care we are in the business of relationship - whether we like it or not. So what do I mean then when I talk about love based MH care?
For this service it is twofold:
- Self-love - this incorporates all of the levels of relationship indicated above. A sense of fondness for ourselves as people, being our own best friends, having a healthy sexual relationship with ourselves and loving ourselves unconditionally regardless of our size, health, difficult behaviours etc.
- Agape - Unconditional love for others and an acceptance of who they are where they are. This love does not mean that behaviour that is destructive or illegal is accepted, it means being boundaried and clear without judgement. This is the sort of love that people who care for others show - teachers, nurses, doctors, parents. When I was a student nurse we called it 'unconditional positive regard'.
Somewhere along the line, since the time I signed off as a MH nurse in the late 80s, we have lost that love. The individual practitioners within health care may not have lost it, but the service has. In MH care staff leave in their masses, burnt out from not being able to care for people in a system that has lost its way, or been led astray by decades of consistent underfunding and political meddling. A system that can be actively damaging - leading many of those who have used services to describe themselves as survivors. This is a thing of shame for any service that holds itself up as a caring organisation. In 2011 Crawford and Hallawell wrote an editorial asking where is the love in healthcare? They called for NHS and private companies to build services that are conducive to humane and compassionate care. Let's call a spade a spade though - compassion is a form of love.
So, this is a call to action, will you join me in heralding the new generation of love based MH care?