When we work with others, and our work involves caring for and about them, how far is too far? When we need to walk in someone else’s shoes, in order to support them to make the best choices they can, how do we avoid slipping into those shoes too? How do we preserve who we are when we spend our days – and often nights – trying to understand how it feels to be someone else?
Every time I am complimented on my people skills, or thanked for being so understanding, I feel a warm sense of homecoming, a recognition that I am in the right place, the right role for me; that my values and beliefs, my creed in life, are being of use. And yet every time that happens I should remember that pride comes before a fall, that it will only be a matter of days before I cross one of those invisible lines that we call boundaries, in our work with the public. All the so called helping professions have their boundaries and whilst most of us will have had some education around this notion, most of us will still feel that there are days we don’t quite stay in our boxes.
A recent session with a group whose frustrations I understood and shared, led me to say something “between these walls,” which I later regretted. I should know that if I preface an utterance with “between these walls,” or a similar phrase, meaning “please don’t repeat this,” that I should stop at “walls” and go no further. So what makes me not able to do that?
Emotion. A desire to help. Frustration with the bigger context outside of these walls. A personal need to feel that despite the constraints put upon me by that context, I am still a person in my own right, with my own views and my own agency to act. I did not make the policies and regulations by which I am bound, even if they are not documented formally, and just once in a while I want to show more support than the official, organisationally restricted version in whose name I am working.
But once I have done that, been true to my personal creed over the collective one which employs me, I can hear the voice of the Sat Nav in my head, as it says, with that disappointed sigh: “Re-calculating.”
A wrong turn. Naughty me. I am having to make the Sat Nav work harder to redirect me. Re- calculating. Re- directing. Re- assessing. It all sounds so punitive. I have stepped out of line. Is that what boundaries are all about? Keeping us and our actions in line?
All professions have boundaries and customs and rules and norms, and that’s how they maintain their identities as professions. It’s how we maintain our identities as professionals and I am not suggesting that this is wrong or that we stop doing it. My question is, how do we maintain our own identities in the face of these collective identities? We know that patients, learners, people who need our professional help, can benefit from our professional expertise, honed over years and influenced over centuries of professional evolution. But we also know that people respond positively to the humanity that goes beyond these boundaries. A doctor may diagnose our medical problem, a nurse may instigate treatment for that problem, a teacher may help us to practise something more effectively, but what makes all of those interactions more than just a transaction, is the humanity with which it is accompanied.
I will never forget the consultant gynaecologist who sat on my bed and compared with me how much urine we had each produced from our post operative catheterisation. The knowledge that four months previously he had had the same intervention as I had, albeit for a different surgical procedure, bridged the gap between us; we were first and foremost people, our medical relationship secondary to that. All at once I felt better: less afraid; less alone; less abandoned on one side of the medical ravine that had clinicians on one side and me as a helpless patient on the other.
The ravine is an image I revisit regularly. As humans we tend to polarise our views into one thing or another, and the image of two sides of a large gulf is one that I find helpful. But there are many ravines, and when it comes to boundaries and to my identity within my profession, I sometimes see myself in the depths of the ravine, being pulled by those on either side. On one side is the profession, with its behavioural expectations, it’s norms, and on the other side are the people this profession exists to help. When I am pulled between the needs of both, I feel my own identity and purpose is lost in the struggle.
Maybe, at the end of the day, the needs of a profession and the needs of those who are served by that profession are not entirely compatible. As members of the profession who seek to serve those we serve, we occasionally face a dilemma – to support one means to retreat from the other. In making a decision to privilege one over the other, we fall back on our own creed, we are driven by what feels right, responding to the embodied expertise we have developed over time. Only later might we spend time repenting at leisure that we may not have stayed within our boundaries.
Maybe this is why I spend some of my weekends, re-calculating.