Profound respectfulness

Profound respectfulness involves:

• belief in agency, knowledge and resources held by the people we serve
• holding this belief even in the face of apparent evidence to the contrary
• valuing of these personal resources
• commitment to bringing them forward into consciousness
• an attitude of optimism based on this valuing of this resilience
• the belief that people consulting us are better off living their lives in the way they choose, by their own values and intentions.

In asking a question the focus is:

“what can I learn here about the knowledge, values, resources this person has which will enable movement?”

rather than:

“what are the vulnerabilities and pathologies which have led to this dysfunction?”

One way of illustrating this is the difference in attitude when inquiring of a colleague whose competence we respect, or a colleague whose competence we doubt, as to how they made an unexpected clinical decision. Where competence is respected the inquiry is made in the hope of learning something, the implication being that if this competent person made a decision we would not have made, that this is likely to be because they have some knowledge or understanding we could learn from. In the latter case the inquiry is made with vigilance for deficits in competence. In collaborative clinical work, inquiry is based on the attitude of profound respectfulness for the person’s resourcefulness and personal knowledge. We are making the inquiry in the hope of bringing forward knowledge which we can learn from and which is likely to be an important component of enabling forward movement. This goes a lot further than the non-specific stance of 'unconditional positive regard' advocated by Carl Rogers. It implies commitment to positive action towards discovery, discovery of what might not be evident to us or the person themselves, without our endeavours.

There is an Arabian proverb which is helpful here:

A friend is one to whom one may pour out all the contents of one’s heart, chaff and grain together, knowing that the gentlest of hands will take and sift it, keep what is worth keeping and with a breath of kindness blow the rest away

To practice collaboratively we need to believe in the existence of the grains, regardless of how obscured they are by chaff, value the grains, exercise tenacious commitment to, and develop skills in, clearing the chaff and bringing them forward. This is a particularly challenging task in the context of severe mental illness, part of the chaff can be cognitive disorganization, delusions, hallucinations, etc.