Step Away from the Addict!

March 7, 2008 3:39 PM

How to demonstrate empathy, concern, and warmth without physical contact?

I'm getting a master's in counseling and am highly attracted to treating people with substance abuse (preferably women).

When I feel deeply for someone, I feel the need to hug them/ squeeze their shoulder/hand to transmit my caring. I think I do this because hugging and touching is the most honest way I can think of to communicate with the people I care about, but my mentors have brought it to my attention that physical touch may not be appropriate in all situations and with all people.

I don't have a problem expressing myself verbally as well, I know that some/many people find kind words insincere.

So my question is, how can I express empathy for someone without speaking and without touching them?

posted by mynameismandab to human relations (8 comments total)

Listen to what they say. Make eye contact. Mirror their posture with your own (if appropriate). Nod. Hand them a box of tissues when they tear up.
posted by Carol Anne at 3:49 PM on March 7, 2008 [1 favorite]

I worked with at-risk youth for about 3 years. Besides the fact that a LOT of them associated adults touching them with bad memories, it was a big no-no to engage in physical contact. Hugging, holding someone's hand, etc all that was OUT...basically, a high-five was the extent of my physical contact with the kids.

A lot of the women I worked with were also VERY touchy-feely. Some noobs always found it hard not to touch the kids (they weren't doing ANYTHING inappropriate...but hugging a kid whose neighbor/grandpa/dad/etc told them that physical contact leading to sexual abuse can totally send the wrong message.

In my experience, (I am no expert, but I'm also not a dummy) "kind words" can be insincere because the recipient may NOT be used to niceness AND they may take it as meaningless. Even "I love you" loses its meaning if you say it to everyone.

I was a hard-ass on the kids. Not the kind of hard-ass that was mean to the kids, but I was kinda stoic. I was helpful in any way that they asked (or in any way I figured I could help without making it seem like I had to exert myself to help them). I was a professional.

During the times that a kid was going through something REALLY huge, or REALLY needed a friend, THATS when my personality would come out. Not 100%...but even a small smile could make their day when it came from the hardass.

I made it a point to KNOW about the kids, and connect with them on some level (whether it be something serious, or something like "I like the Cubs too"), before I tried to connect with them. THAT is what made a big difference.

If you feel you are doing this because they need your help, or caring, or kind words...you are gonna get a emotional smackdown by one of the people you work with. You are doing this because it is your job, not to "save the world". You aren't better than anyone. Sure they might be in this place as a patient and you aren't...but that doesnt mean they have more to learn from you than you have to learn from them.

Just start out as the "I don't know anything...feelings and interaction are new to me", and you'll be alright. Don't consider yourself an expert in human interaction. You'll be making an impact soon enough.

Good luck. I mean it.
posted by hal_c_on at 4:01 PM on March 7, 2008 [1 favorite]

Your mentors are right. Physical contact is never appropriate in a professional relationship. But kind words ... well, the sickly sweet "aaah poor you" kind of empathy is certainly going to be interpreted as insincere however it is meant, whereas words that demonstrate you've really heard and understood what your client is saying to you, while giving them maybe a little more insight into their own condition, there's little chance they will come across as insincere.

The technique you're after, I think, is active listening. It's incredibly hard work, and a difficult skill to acquire but so effective when you get it right. I know you asked how to express empathy without speaking, and speaking is a key part of active listening. But if you're doing it properly, every aspect of your behaviour will tell your client in a thousand and one subtle ways that you have their interests at heart.
posted by genesta at 4:21 PM on March 7, 2008 [1 favorite]

Be totally present in the moment and look them straight in the eye. Be very aware of your facial expression. When I'm sharing something tough, I just want people to look at me like they're not uncomfortable hearing about it and/or bored.
posted by HotPatatta at 5:32 PM on March 7, 2008 [1 favorite]

Listen! Listen! Listen! And be aware that each person with addiction is different and that the disorder is highly, highly stigmatized and you may be buying into and reinforcing stereotypes about it without even realizing it. Read the research-- do not just be guided by what is done in clinical practice-- much of this is ineffective, and worse, harmful. Be aware that for some people, eye contact is a threat. Be sensitive above all.

Most of what is taught and reported in the media about addiction-- even by so called experts-- is wrong. No one recovers without treatment? Wrong-- actually most do! Addicts require tough love and confrontation and being cruel to them is being kind? Wrong-- this actually hurts rather than helps! There's an "addictive personality"? Wrong, some addicts have none of the so-called personality traits associated with addiction and virtually none have all of them.

No one can return to controlled use of a substance if they've ever had an addiction? Wrong-- many addicts to one substance have no problems with others and a very rare few can even learn controlled use of drug of choice! 12 step treatment the only way? Wrong-- many people find them unhelpful! 12 step programs bad for everyone? Wrong-- many people thrive in them! Methadone is just like substituting vodka for gin and not "really" recovery? Wrong-- Institute of Medicine says its most effective treatment for opioid addiction! I could go on...

As a female ex-addict who has had lots of harmful encounters with people who supposedly wanted to help me and who has interviewed hundreds of people whose "treatment" experiences were at least as traumatic as their drug use and some seriously more so, I urge everyone interested in this field to be very, very careful about what they do.

There are lots of people out there who will try to convince you that we only respond to brutality -- don't drink the kool aid!
posted by Maias at 6:09 PM on March 7, 2008 [1 favorite]

I agree with hal_c_on- you should focus on being an emotionally strong helper/guide in their recovery. Showing too much empathy, concern and warmth could hinder your clients' ability to talk freely, because they might become connected to your emotions. In other words, they'll hesitate to share for fear of affecting you, or "bringing you down". And/or they could misinterpret you as their friend, and not the friendly professional that you should be to them.

Be careful with active listening- it's been used as fodder for comedy because if you do it too much it becomes very insincere sounding. People will pick up on the fact that you are doing something, rather than just listening. It's an important tool, but best used sparingly.
posted by gjc at 6:14 PM on March 7, 2008

Listen, sure, but there's the kind of listening where you're just hearing what people are saying, and then there's the kind where you draw people out. For example, where I work is right around the block from a city shelter, so we get our fair share of weirdos, space cadets, sad sacks and the like. Over the past couple of years' worth of cigarette breaks I've heard a couple dozen life stories--all unsolicited. What I've found is that you have to not just listen to what's being said, but get a feel for how open or closed the person is. Sometimes people just don't feel like talking, you have to respect that. But other times, it'll seem like they don't want to talk, but in fact they're looking to unload a bunch of personal problems but don't want you to know they kind-of need you.

This happens all the time... I'll be propping up a building smoking a cigarette, someone will ask for a smoke, then they'll just kind of linger. Maybe say something outrageous just to gage your reaction. A couple of days ago a guy informed me he just landed on Earth. Now, how do you play that? You could do the standard repeat what they said back to them thing... "Oh, just landed, you say?" But that's not going to get you anywhere. Someone says something like that, they're challenging you... seeing what you're all about. Me, I tend to rely on the inquisitive-but-suspect, empathetic-but-untrusting "Oh yeah...?"

I guess the key to remember is that the person talking to you has to feel like the ball is in their court, but if they do play, you're not a sucker. Call them out if they lie, disagree if they're wrong... but no judgments and don't ask for anything. Basically, you can do whatever you like with what they give you, but they have to be the ones to offer--you can't ask them for it. Nobody wants to talk to a parrot, but no one wants to talk to their mother, either. When I get one of the crazier people that I feel a bit wary about, I have to be careful to balance the two. Personal anecdotes are helpful, because then you're not talking about their specific problem or passing judgment on their mistakes, you're sharing your own story, and can feel however you like about it.

For instance, a couple of weeks ago a guy was telling me how much this country has gone to shit, and how he wanted to kill all the politicians and CEOs. A bit unsettling when you're just trying to have a cigarette in peace. But I can understand where he's coming from... until he starts talking about the foreigners and how they're ruining this country, too. So I interject, "No way, man. This country was founded by foreigners. Shit, I used to work in a kitchen with some Mexicans and they worked, like, fourteen hours every day. I'd rather have them running this country than some silver-spoon asshole that doesn't work a day in their life."

I'm paraphrasing, but the point was threefold: 1. Offer an innocuous personal anecdote, but don't try and make it about "me"; 2. Don't just nod my head in ignorant agreement with everything he said, because they he knows I'm just placating him and not really listening to him, which will only make him more irate; 3. Disagree with him in a way that he can agree with... He's already told me he hates the big corporate "fat cats," so I re-frame the argument in such a way that it's either...or. Who do you hate more, Mexicans or Corporate Overlords? After that he dropped the whole immigrants angle and started talking about how he hasn't been able to find work for months and he can't afford his meds. Aaah... now the picture comes into focus.

I don't know if that makes any sense... I'm not explaining it very well. A lot of this you just have to feel out as you go.
posted by Civil_Disobedient at 8:43 PM on March 7, 2008 [1 favorite]

I think that if you are going into this kind of career, and are asking this kind of question, it's not something you have to worry about in the slightest. No one is going to mistake you for an ice queen.
posted by desjardins at 9:00 AM on March 8, 2008