direction. Vikki Reynolds’ ideas of ‘doing solidarity’, and of actively ‘leaning in’ towards ethical transgression seem very relevant here – we must pay attention when we feel pain, and use it to guide action to repair (2012). In meeting with the social worker, Louisa was able to ‘resist blame’ and instead acknowledge the limits and pressures of the systems in which they worked. They were able to re-establish a ‘collective ethic’ and stand together rather than apart in their relationship to the family and the wider systems in which they worked. We note that many instances of ethical pain, like Louisa’s
above, have nothing malign in intention. Perhaps this is a more insidious problem than deliberate ethical transgressions, as it is instead ‘busyness’ and overwork that can lead us down a path where the opportunities and space to notice and respond are reduced. An example of this is our inaction in the face of the ending of funding for the Transforming Care programme. We are outraged that this may come to an end, and want to take action to force the government to find further money to continue to fund this important programme. But, like the brambles, we have thought about these issues only intermittently, and haven’t prioritised them sufficiently to come together to take action. It seems ironic that in our desire to do a good job and keep up with the demands on our time, we have actually lost the thinking space to prioritise and therefore to act when we see ethical practices at risk.
Holding a tenacious relationship to hope At times, we have felt overwhelmed by spiritual pain, by the
limits of our responding and have nearly fallen into practices of learned helplessness and of cynicism. In Vikki Reynolds’ work, we find an antidote – we find hope and light and promise. We want to talk to you about just a few of the ethical intentions that she outlines that we attempt to embrace. Remembering the rhizome: Vikki speaks of a single shoot of a bamboo plant, with roots that spread horizontally through a complex rhizome system, meaning that a single bamboo plant can become an entire field. This beautiful metaphor has many resonances, but says something to us of the ways in which we are interconnected, and how it is in these connections that sustainability and growth can occur. We therefore commit to continue to remember each other, to be “good enough allies” (Reynolds, 2012, p. 23) to each other in order to foster our collective sustainability. Sustainability and collective care: Vikki also reminds us that, however imperfect, our work matters. And that we should look beyond ‘standard outcomes’ and measure the immeasurable – things like “doing dignity and fostering safety and belonging” (2012, p. 25). This had strong resonance for us all, particularly for Nina in her noticing of the practices of a colleague: Nina: I was talking with a man, who describes himself as living with an intellectual disability and autism, about his experience of meeting with an assistant psychologist, Ladan. The man said that Ladan was very helpful, that she was a “bridge” for him. He did not describe what she did, nor how she was helpful, other than that she was there for him. Ladan was patient, very knowledgeable about autism, and was creative in adapting her approaches to his needs. I felt moved and sustained by this man’s sincere depiction of Ladan’s actions and their therapeutic relationship. I realise
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now that it wasn’t so much the witnessing of the many skills that touched me, but hearing how Ladan was fully ‘present’ over time, how she was able to hold on to hope in a respectful and patient manner, becoming a ‘bridge’ between a difficult period and something better. This reconnected me with my own ethical stance that relationships need patience, respect and cannot be rushed, and then they can become the bridges to places of hope. ‘Giving it back’ practices: We were moved by Nina’s telling of this story, and thought it would be important for the assistant psychologist to know of the impact of her work on our collective sustainability. Vikki talks of this as the practice of ‘giving it back’ and describes the ‘ethical obligation’ we have to ensure that our colleagues know the ripples of the work that they do, in both the lives of their clients and colleagues. We’d therefore like to enact the practice of ‘giving it
back’ by mentioning just a few people whose work has made a difference to us. This practise can be both personal and public but to remain in a more personal domain we only use a first name in this article. Firstly, to Vikki for these wonderful ideas and inspiring us with her strength and passion for social justice. To Adriana, who as a tutor and systemic therapist has taught us so much about ‘being’ relational as opposed to ‘doing’ relational work. To Pippa, a supervisor, who demonstrates ‘being’ relational through many a cup of Yorkshire tea. To each other for continuing the commitment to hope. To those who train and work at the University of Hertfordshire who remind us that small pebbles can make big ripples. And to Lizette, a colleague, for her relentless pursuit of ‘justice-doing’ and inspiring us to take our conversations to a wider audience. And so to conclude, our work requires a commitment to
being honest with ourselves, however uncomfortable this may be, to renew and crucially to act out our ethical ideals. In these difficult times we align with Vikki Reynolds’ ideas of solidarity, of actively seeking connections with colleagues, carers and those who use our services. In doing so we find in others the hope and commitment to sustain us.
References Gleeson, B. (2010) Counterpoints of care: Two moments of struggle. Journal of Intellectual Disability Research, 54: 5-15. Head, A., Ellis-Caird, H., Rhodes, L. & Parkinson, K. (2018) Transforming identities through transforming care: How people with learning disabilities experience moving out of hospital, British Journal of Learning Disabilities, 46: 64-70. Johnson, K. (1998) Deinstitutionalisation: The management of rights. Disability & Society, 13(3): 375-387. Mansell, J. (2006) Deinstitutionalisation and community living: Progress, problems and priorities. Journal of Intellectual and Developmental Disability, 31(2): 65-76. Reynolds, V. (2011) Resisting burnout with justice-doing. The International Journal of Narrative Therapy and Community Work, 4: 27-45. Reynolds, V. (2012) An ethical stance for justice-doing in community work and therapy (with a response by Marcela Polanco). Journal of Systemic Therapies, 31 (4): 18-33.
Nina Viljoen, Helen Ellis Caird, Louisa Rhodes and Annabel Head are clinical psychologists who work in the NHS in mental health and community services for adults with intellectual disabilities and autism. Helen is a clinical lecturer at the University of Hertfordshire. Together, Helen, Louisa and Annabel are involved in research, teaching and writing. They engage in the telling of the untold and unheard stories of persons with intellectual disabilities (see for example, Head et al., 2018). Email:
n.viljoen@
nhs.net
Context 164, August 2019
Supporting people with intellectual disability and autism – resisting burnout and preventing sleepwalking: A conversation between systemically minded psychologists
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