Does mental health support work get easier or am I maybe not cut out for it?

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astralpsy
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Does mental health support work get easier or am I maybe not cut out for it?

Post by astralpsy » Tue Mar 03, 2020 8:39 pm

I'm in very confusing point in my life where I'm trying to figure out my life after having left my life-sucking corporate job.
I've always had a great passion for psychology and decided I will do a conversion MSc in September. I have clinical psychology as my primary area of interest, but I am also open-minded to other areas which I will be taught during my MSc.

In order to prepare me as much as possible for my MSc (and the future) I got a mental health and addiction support worker role. I've done two shifts shadowing and I am honestly completely emotionally drained and stressed. I suffer from social anxiety and I also have a fear of conflict. During my shadowing they kept on echoing the conflict scenarios and what to do if they get aggressive. Even though nothing happened during my first shift I just feel on edge not knowing what could happen on the next. I don't think I could use an authoritarian approach "STOP! GO TO YOUR ROOM" approach that they recommend during conflict.

During my second shift I met a woman who had severe personality disorder where she acted possessed (exorcism type thing) and I was so shocked and scared when I saw her, I'm scared to approach her on my own now.

As I was walking home I just felt this wave of sadness. I'm not sure if I feel scared because of the social anxiety aspect of me, or because I'm just no cut out for this. I also felt so sad because these patients shut themselves in their room 90% of the time with nobody to talk to. I just want to give them a hug, or talk to them, or make them smile or whatever. I feel like I'm bringing work home with me and I just don't want to be feeling like this every time.

So I guess I just need some advice on whether I should continue with this job (I'm hoping it will develop me rather than traumatize me)? I'm worried that if I'm not cut out for this, am I cut out for a clinical psychologist role? Any advice would be appreciated.

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maven
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by maven » Wed Mar 04, 2020 4:22 am

In my personal opinion this doesn't sound like the right job for you. It wouldn't be fair on the recipients of the service to have a worker who is afraid of them and talking about people who have experienced a lot of trauma in the past and are in a state of acute distress like aliens that you can't relate to human being to human being - though I also think the language you have picked up* suggests it isn't a setting that has a good model and ethos. The fact people choose to lock themselves in their room also speaks to the culture there.

As to whether this means that working in mental health is not the right choice for you, I think only you can reflect on your experience and decide. Not all clinical psychologists work with adults in acute distress. Many work with older adults or people with learning disabilities, in day centres or charities, or with children and young people in schools or children's homes, so you could try to work in another setting. But the nature of the work is that most of us do speak to people in distress and hear their stories, so it is emotionally demanding and requires a certain level of robustness in your own mental state to manage, and you really need to think why you are drawn to the profession and whether this would suit you before you invest many years in trying to convert and gather experience and compete for training places and study for three more years.

What is it you see yourself doing that attracts you to the job? Do you really know what jobs in therapy and mental health really involve? And will you enjoy the process and/or the destination, or is it just an abstract idea? That isn't to say that CP is off limits if you have experienced mental health problems yourself, just that they might make it harder, and that they probably need to be quite well managed to make the role viable. For example, clinical training will expect you to work in a wide variety of placements, and many will be potentially anxiety provoking if you have social anxiety.

*Just to pick out a few bits:
what to do if they get aggressive
they are us and we are them, and I have no doubt that any one of us could be acting that way if put under enough stress
severe personality disorder
a much disputed label given to people who have experienced chronic and unresolved trauma at the hands of people they should have been able to trust
where she acted possessed (exorcism type thing)
People don't act out roles, they express their distress when they feel overwhelming fear (eg from flashbacks of past trauma), and they don't behave in unusual and dysfunctional ways out of choice, they do so because they are adapting to their experience (eg not being given nurture or support when they needed it, being abused traumatised and shamed, and an often well-justified lack of trust in professionals).
these patients
That's a construct of the medical system. They are people first and foremost. Whether they want to be called patients should be up to them, but we need to be aware of the unhelpful elements of the power dynamic involved.
"STOP! GO TO YOUR ROOM"
I also wasn't a fan of the description of shouting at clients in distress. They need someone being calm and helping them to feel safe if they are in an emotionally dysregulated state, so it seems counterproductive to be loud and aggressive.
Maven.

Wise men talk because they have something to say, fools because they have to say something - Plato
The fool thinks himself to be wise, but the wise man knows himself to be a fool - Shakespeare

xxpoogletxx
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by xxpoogletxx » Wed Mar 04, 2020 2:39 pm

Hi astralpsy,
I remember my first experience as a support worker (5 years ago now), working in a low secure forensic setting with individuals with learning and neurodevelopmental disabilities. I can tell you for the first few weeks I felt scared. Mainly because I felt like I had no idea what I was doing and I was terrified of saying or doing something wrong. However, over the course of a few months, once I built up my confidence this fear dissipated. That's not to say I was never in a situation where I felt anxious, frightened or threatened, I just felt better equipped to deal with this and had a better understanding of how the people I was supporting might be feeling in these situations.

As Maven says, the individuals we work with in mental health settings are people just like me and you. If they are expressing their distress in ways that are scary or unusual to us, imagine how frightened or confused they must be feeling. I currently work as an AP in an acute inpatient setting and the medical model of mental health 'treatment' IS often abusive, coercive, threatening and oppressive, so it is not surprising that people experience it as such. I do not know how I would react if I was in distress and I was sectioned and 'treated' against my will. That being said, I love my job. I work for a service that is becoming much more open to thinking in a more psychologically informed way and really is trying to strive for person-centered care. Part of the reason I love it is because it is a fast-paced, think-on-your-feet, unpredictable environment. However, this sounds like it might not be a good fit for you? Which is completely fine, there are lots of other settings and areas you could work in.

Also I would have a think about some of the language you used in your post (as Maven has pointed out). I balked at the 'Stop! Go to your room!' approach that has been recommended, which you have rightly identified as being authoritarian. I cannot see how this would ever be the right way to speak to a person in distress and I have witnessed staff in previous jobs use this approach. Also you mentioned that people are spending 90% of their time in their rooms, have you thought about why this might be? Is it not part of your role as a support worker to try and engage people? You could encourage people to spend some time talking with you, partaking in activities, watching a movie together, cooking together, going for a walk? These are all things my support worker colleagues and I would do.

Ultimately only you can decide if you think this is a job that is right for you, is it just new job nerves, or is it that this setting isn't for you? Also you mentioned having a 'great passion for psychology', what does that mean? How much do you already know? Why clinical psychology? I would also suggest reflecting on your emotional boundaries, if you're already feeling emotionally drained and stressed after just two shifts and taking work home, why is that? Working in mental health means that you are often privy to people's distress and trauma and it requires a level of emotional robustness to be able to hold and contain someone else's distress.

AnsweringBell
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by AnsweringBell » Wed Mar 04, 2020 4:08 pm

xxpoogletxx wrote:
Wed Mar 04, 2020 2:39 pm
Hi astralpsy,
I remember my first experience as a support worker (5 years ago now), working in a low secure forensic setting with individuals with learning and neurodevelopmental disabilities. I can tell you for the first few weeks I felt scared. Mainly because I felt like I had no idea what I was doing and I was terrified of saying or doing something wrong. However, over the course of a few months, once I built up my confidence this fear dissipated. That's not to say I was never in a situation where I felt anxious, frightened or threatened, I just felt better equipped to deal with this and had a better understanding of how the people I was supporting might be feeling in these situations.

As Maven says, the individuals we work with in mental health settings are people just like me and you. If they are expressing their distress in ways that are scary or unusual to us, imagine how frightened or confused they must be feeling. I currently work as an AP in an acute inpatient setting and the medical model of mental health 'treatment' IS often abusive, coercive, threatening and oppressive, so it is not surprising that people experience it as such. I do not know how I would react if I was in distress and I was sectioned and 'treated' against my will. That being said, I love my job. I work for a service that is becoming much more open to thinking in a more psychologically informed way and really is trying to strive for person-centered care. Part of the reason I love it is because it is a fast-paced, think-on-your-feet, unpredictable environment. However, this sounds like it might not be a good fit for you? Which is completely fine, there are lots of other settings and areas you could work in.

Also I would have a think about some of the language you used in your post (as Maven has pointed out). I balked at the 'Stop! Go to your room!' approach that has been recommended, which you have rightly identified as being authoritarian. I cannot see how this would ever be the right way to speak to a person in distress and I have witnessed staff in previous jobs use this approach. Also you mentioned that people are spending 90% of their time in their rooms, have you thought about why this might be? Is it not part of your role as a support worker to try and engage people? You could encourage people to spend some time talking with you, partaking in activities, watching a movie together, cooking together, going for a walk? These are all things my support worker colleagues and I would do.

Ultimately only you can decide if you think this is a job that is right for you, is it just new job nerves, or is it that this setting isn't for you? Also you mentioned having a 'great passion for psychology', what does that mean? How much do you already know? Why clinical psychology? I would also suggest reflecting on your emotional boundaries, if you're already feeling emotionally drained and stressed after just two shifts and taking work home, why is that? Working in mental health means that you are often privy to people's distress and trauma and it requires a level of emotional robustness to be able to hold and contain someone else's distress.
This is a super, super good and thoughtful reply. Totally agree.

Also... not going to make the same points Maven and xxpoogletxx have made re language and medicalised approaches (and I know as a CSW you really aren't involved much in challenging these things - especially in your first role!)... but I wanted to echo that secure or acute inpatient services really are quite niche, and there are a lot of hierarchical, non-therapeutic systems in place that should really be dismantled. But they exist and when you're in it, you sort of end up bending to them a bit too (even when you are actively trying to change things). SO while I'd also encourage reflection on why clinical psychology, what you think you'd like to do, what you think of 'clients' and how you'd like to work... please know that these sorts of settings really aren't for everyone, and I had loads of people in my cohort training who just hated inpatient or forensic placements. Just hated them. Felt intimidated or frightened, often unsafe, and just generally didn't feel good about working with people under section. It doesn't mean you cant or shouldn't be a clinical psychologist, at all, if you don't feel safe in a setting where there's regularly violence and aggression.

Especially with all the emphasis in recent years on care being primarily in the community and close to home for our clients, there are an abundance of others areas to work in (as an assistant or clinical psychologist). Just do that important reflecting work to figure things out for yourself, I think.

(Just reflecting myself on some of the practices that happen where I work still, particularly in terms of PMVA and language used. Even with a really strong, big psychology team... If I worked here for my first job as a CSW... I think my perspective on psychology generally and person-centred care might be skewed too).

astralpsy
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by astralpsy » Wed Mar 04, 2020 8:57 pm

Thank you for your replies. I apologise for not using the right language (english is not my first language and I may express myself in the wrong terms).

What I mean by passion for psychology is hard to explain. I spend much of my free time with a lot of psychological literature, movies, podcasts etc.
I've suffered from severe depression and anxiety in my early 20s and since then I always analyzed even the smallest things.
I'm fortunate to have very smart people around me who I can discuss different topics in psychological depth and I've been told I should become a psychologist because I seem to be able to understand situations and the meaning behind them quite naturally. It gave me a bit of confidence to something I have been pondering on for a very long time.

Why I thought of clinical psychology was because I liked that it was patient-facing but also a bit of research involved (I don't want only one or the other). As mentioned I will get to explore a lot more of psychology during my studies and this may change. I thought mental health support work would give me a bit of a trial into the field, but after my third shift today I just doubting if I'm cut out for this setting. It came across wrong when I said patient, I of course see them as human beings and that's a big part to why I feel so distressed. I feel like it could happen to anyone of us and I just start thinking about what they have went through to get to this point, and how they must feel inside. I go into this spiral of sadness and by the end of the shift I feel like my brain has been fried and I have no energy to speak to anyone.

I guess I asked here cause I wasn't sure if this was normal to feel this in the beginning. I'm pushing myself because I feel like if I can't go through this type of work would I really be suited as a psychologist? And I suppose it's nice to hear that it does not necessarily mean so.
I also feel bad for quitting now when I've signed a contract and they expect me to work, and my friend referred me so I don't want him to have to deal with the questioning of why I disappeared.

I just feel a bit lost right now. Should I try it out a bit more or get out?

xxpoogletxx
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by xxpoogletxx » Thu Mar 05, 2020 12:35 pm

I think only you can answer whether it feels right to carry on, or whether to just accept that perhaps this setting isn't right for you and leave. It's difficult to decide as it seems like this is your first foray into working in mental health, and it can be difficult, scary and overwhelming at first.

My concern would be that you seem to be tipping over into overidentifying with the individuals you're supporting, rather than holding an empathic and compassionate stance. This is not helpful for the individuals you are working with and is not healthy for you. Given your previous experience of mental health difficulties (which I feel can be a huge strength in a practitioner if appropriately managed) it is even more important to notice this in yourself and to maintain robust emotional boundaries. I work with people in acute distress and many of the people I have worked with in my career so far have experienced abuse, neglect and trauma. It can be emotionally draining and it is hard to read and hear about peoples' distress and life difficulties. However, I am able to listen, empathise, contain, process and then get on with my job. If you are feeling so overwhelmed by peoples' distress after just a few shifts you are heading quickly towards burnout and compassion fatigue. I'm wondering why it is that you're feeling so affected by other people's distress? Of course it is upsetting, but perhaps have a think about ways in which you can manage this. For example; talking to other staff, supervision or reflective practice (if this is available to you), trying to focus on the positives in the job (such as engaging in activities and 'fun' things with people), being able to switch off when you get home, self-care.

It can take time and practice to work on ones' boundaries and to feel comfortable and capable in a new job. But staying in a job that isn't right for you is also not necessary. I think you have to decide whether you think how you're feeling right now is something you can work on and is likely to get better/easier, or whether this is just not the right job for you. Maybe trying to speak to some of your colleagues to see how they felt when the first started and how they cope with the emotional difficulties of the job might help you decide?

astralpsy
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by astralpsy » Thu Mar 05, 2020 1:42 pm

I think you hit the nail on its head when it comes to overidentifying with the individuals. I'm a very sensitive person and sometimes I feel like I can feel people's energies and feelings just by looking at them (I realize this may sound strange). It's a double-edged sword and I would really like to learn how to be able to shut off sometimes. I don't want to keep myself awake at night every time I feel sad over something that's out of my control. I'm hoping this job may push me to be able to set those boundaries. I have my final shadow shift today, so I'm hoping to gain a bit more clarity after this.

I will try and speak to some colleagues about this.
Thank you for your advice. It's been most helpful.

lingua_franca
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by lingua_franca » Sun Mar 08, 2020 1:39 pm

First of all, your English is very good and I wish I were as fluent in my other languages. :) But it may be causing some subtle obstacles in communication. For example, when you say that you feel drawn to psychology because you "analyse even the smallest things" following your experiences of anxiety and depression. This might be a language issue, but many people seem to confuse psychology with Freud and psychoanalysis, and think it's about searching for hidden meanings in every tiny thing when this isn't an accurate picture. Do you have a clinical psychologist on the ward where you work? If you get the chance, talking to them and just seeing what they do from day to day should help you to gain a deeper understanding of what's involved.

As others have said, CPs work in many settings, and not being a good fit for a role in an inpatient addictions service doesn't mean you wouldn't be able to work elsewhere. But overidentifying with clients and getting overly drawn into their distress is going to cause issues in any service, and it sounds as if therapy and good supervision would be helpful in addressing that.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

astralpsy
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by astralpsy » Sun Mar 08, 2020 7:42 pm

Thanks for your reply. Indeed the analyzing part came out wrong. I mean it in that I'm naturally interested in the meaning and reason behind human behaviour and the mind.

There's no CP in the ward. You're mainly there to support them with preparing food and cleaning communal places and being there if they want to talk to you or need anything. I was hoping the role would be a bit more active their days/lives but I'm sure I will still learn a lot.

I think I will maybe look at some books in clinical psychology to get some more insight. This forum is also very helpful.

dfling
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by dfling » Mon May 25, 2020 1:23 pm

Hi astralpsy

I just wanted to reply to your post as I empathise with your position of finding support work difficult.

I think responders here have raised good points, but I also want you to know you are not alone in finding that type of work challenging. The working conditions and culture can make it very difficult to maintain a removed, empathic stance. From personal experience, feeling quite burnt out and exhausted in support work could make even the fundamentals of focus and concentration very difficult. I left support work after 6 months.

I'm about to begin the doctorate this September having worked in lots of different settings since, such as research and AP work. Working in the NHS has given me a much more concrete idea of the role of the CP and, even though I didn't feel that support work was right for me, it didn't stop me from pursuing a career as a CP. Good luck with the role - even if you decide not to stay, I'm sure you'll have learnt some valuable things along the way.

altruisticmall
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Re: Does mental health support work get easier or am I maybe not cut out for it?

Post by altruisticmall » Thu May 28, 2020 6:43 pm

maven wrote:
Wed Mar 04, 2020 4:22 am
In my personal opinion this doesn't sound like the right job for you. It wouldn't be fair on the recipients of the service to have a worker who is afraid of them and talking about people who have experienced a lot of trauma in the past and are in a state of acute distress like aliens that you can't relate to human being to human being
I think this is a harsh assessment of the poster's message. The poster expressed fear and anxiety around encountering a person in acute distress. If you are just beginning your career in mental health and/or in a role that isn't particularly supported, and/or a culture that doesn't promote recovery, it is not unusual to feel shocked, scared or unable to relate. The idea that someone new to mental health work would have the skills, insight or language to readily cope with this scenario is not realistic. While this may not be fair on the recipient in these initial instances, there is also the opportunity for the poster to learn, grow and develop. I do not agree that it isn't the right job. With more time and experience, it could well become that.

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