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Dealing with Harm

by Nancy Blake(more info)

listed in complementary medicine, originally published in issue 141 - November 2007

The starting point, of course, is love. Or whatever name we have for that force in the universe which first brings life about, then flows through living beings as they survive, reproduce, feed and protect their progeny, their group, their societies.

The fact that you are reading these lines already identifies you as concerned with how that force can be tapped into to achieve good health. If you are a practitioner in a health-enhancing profession, you are committed to using that force to benefit others, and you will have specialist training in a set of skills, techniques, or prescriptions among all the possibilities around us for helping others to achieve good health in spite of harm.

Dealing with harm involves us both in the possibility of being harmed, and of doing harm. The more conscientious we are, the more we may be in danger of depression if we feel we have failed our clients. It is often stated that there is a higher suicide rate among Psychiatrists than among mental patients, and this may be true. The patients are allowing themselves to accept help; the Psychiatrists may not.

It may surprise you that the first rule lifeguards are taught is ‘Don’t go in the water’! Get in a boat, throw a buoy, hold out an oar, a stick, a garment, your hand – any tool you can find, but keep yourself safe. Even when you have learned the skills to swim out and save a victim, that remains a last resort. Drowning people are very strong; they will grab whatever comes to hand and push it under in their efforts to keep above water. If that happens to be you, you will both drown.

The metaphor for us is first, to keep ourselves safe – take care of our own physical, emotional and spiritual health, ensure that we have our feet firmly on the ground, before we try to help others. The next lesson is to use the tools of our practice for helping; avoiding drowning in sympathy or distress for their situation.

Years ago, when I was close to a break-down, emotionally involved with patients in the psychiatric day-hospital setting in which I worked, the Psychiatrist in charge said “Nancy, why are you trying to cure these patients?” I was astounded; I thought that was what we were there to do. I could see the potential in each individual, and I had been trying desperately to persuade them to fulfill my hopes for them. His question made me realize that ‘curing’ them was not my responsibility. My responsibility was to make sure I came to each group-work session on time, in a physical and mental state to concentrate on the task at hand, and to deploy my skills as best I could within that session. The rest was up to them.

The same is true of your clients – keep well, use your skills to the best of your ability, and leave the rest up to them. They have strengths we may not suspect. Respecting their knowledge and understanding of their own situation and condition can help us avoid mistakes. We also need to have respect for our own limitations, and for the expertise of other practitioners, and know when to refer a client to someone else.

But often, our emotional responses to clients give us useful information about them. You can probably think of a time when you were with someone who was bouncy, lively, being the life of the party, and you came away feeling profoundly depressed. You were experiencing the depression which that person was denying and projecting.

Once, interviewing a prospective client for the centre which I ran, his heavy, monosyllabic, passive responses were generating so much annoyance in me that I had to briefly leave the room. When I came back, I said, “I’ve been feeling quite cross; is anger part of your problem?” It was as though a dam had burst. “Yes,” was his heartfelt reply, and he began to be able to tell us what his real difficulties were.

Our immune system works by recognizing what is ‘self’ and what is ‘not self’, and what is ‘a danger to self’. Much of what we work with in our professions is the result of an immune system beginning to ‘misunderstand’. In autoimmune disorders, it perceives bits of ‘self’ as ‘dangerous not-self’ and attacks it (rheumatoid arthritis, for example). In allergies, it perceives an external stimulus (pollen, certain foods, etc.) which is normally ‘not dangerous’ as ‘dangerous’, and launches a response. Alternative and complementary therapies offer many strategies for dealing with these misunderstandings.

We need to generate a similar psychological mechanism, a sense of personal boundaries, within which what we experience is ‘self’ and outside of which is ‘other’. The examples above illustrate what can happen when something that belongs to someone else begins to occupy our own emotional space, and how we can make constructive use of that information in some situations. These ‘counter-transference’ responses are useful when recognized as such, but can lead to harm if acted upon. (It wouldn’t have improved matters if I had acted cross with my interviewee!)

Our lifeline is the love that we have – for our professions, which enable us to be the carriers of that universal love, that life-force, and for the people who come to us for our help. Eric Cassirer tells us that before undertaking any form of healing, we must say to ourselves ‘I have been chosen by God to do this work’. This sounds arrogant, but expresses that healing does not come from us, only through us, as channels for that universal force.

The example of misplaced feelings which is most worrying, for both client and practitioner, is what Psychoanalysts would call an erotic transference/counter-transference – falling in love, (or falling in lust).

By now we all know that many more people than would at one time have been believed possible have experienced some form of sexual abuse. If your client begins to manifest (or elicit) sexual responses within the treatment setting, it is most likely that previous relationships, which should have been caring and protective, have been sexualized. Understanding this, you will know that the most possible healing response is to refuse to enter into the other end of that transaction – to provide, perhaps for the first time, a caring relationship that is clearly boundaried: non-sexual. In this situation, the duty of love is absolutely clear.


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About Nancy Blake

Nancy Blake BA CQSW, has worked in mental health settings since 1971. She served as the Chair of the ANLP PCS (now the NLPtCA), as well as on a National Working Party developing postgraduate standards for Psychotherapy (NVQ Level 5), and contributed to the document which led to NLP being accepted as a therapeutic modality by the European Association for Psychotherapy.  She has presented workshops at UKCP Professional Conferences on an NLP approach to working with victims of abuse, and in psychoneuroimmunology.  Recovering from ME since 1986, she is the co-author, with Dr Leslie O Simpson, of the book Ramsay’s Disease (ME) about ME, as well as A Beginner's Guide to ME / CFS (ME/CFS Beginner's Guides). Both titles are available both in paperback and Kindle formats on Amazon. Nancy was previously enrolled at Lancaster University in a PhD doctoral program; her thesis topic was Conflicting Paradigms of ME/CFS and how the Psychiatric Paradigm creates its Influence in contrast to the Medical Model. She may be contacted via Her books are available to purchase at

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