The components of a healthy relationship
The Relational Worker
Difficulty cannot be deposited somewhere. Left behind, hidden from view, erased from the memory. People do not suddenly feel worthy and able.
The process of change — of opening up emotions, disrupting the mind, and growing a sense of agency — does not map onto a theory of change.
Relationships that can alter the self are messy, unpredictable, complex. But not impenetrable.
Helpers and helped explain how such relationships start, develop, and cement over time.
At the beginning…
At the beginning of the connection, there are two people, each defined by a role. Provider of help and recipient of help.
So the start of the relationship is uneven. People in difficulty appear not to be relating at all. Sometimes, they simply are not there, they do not show up to see their workers. One helper explains: They don’t engage. They hope that you will give up. They crave help but they’ve been disappointed before, and early on they want more disappointment. Other times, people are there only physically. They reveal little to nothing about themselves, as illustrated by this young person.
I find it hard to trust people, and then I don’t think I’ve really had that trust with (my worker) until a few months in, like a good few months in, because I still had my wall up saying like, because I think it was like me thinking in my head that I don’t want to start opening up to someone, telling them about my life, what I think about, what goes through my head, and what I want to do with my life in general. That’s trusting someone, know what I mean?
Non-reciprocity is a testing strategy. Will this worker be different than the previous people who hurt me? So the relating is asymmetrical, the worker invests more than the person who needs help. They continuously visit, call, text, use social media, anything that could lead to a response.
Often, the reply is ‘fuck off’, ‘leave me alone’, to which workers reply, ‘I will see you tomorrow’. Workers describe it as ‘light stalking’. Here’s an example: When I would go missing for a couple weeks, there were times where I would be there. I would act like I wasn’t home, but she’ll come and knock on my door. Is (Janet) here? Is (Janet) here? Is (Janet) here? She’ll come every day. Is (Janet) here?
Relentless reaching out. Not giving up. Over time, it pays off. It starts with minor signs. So, we got the referral, and then getting to see him was a mission, it was a proper mission. So we kept stalking, that’s what I call it; kept stalking, stalking, stalking, and then eventually he came downstairs.
Then there is a common ground
Common ground is built through a personal connection. Normal, two-way conversations, about everyday matters. That is how two people get to know each other, personally. To make it work, the helper steps outside of the professional role.
A worker explains: And we wouldn’t hold a long conversation, but he knew who my favourite team was, I knew who his favourite team was, so whenever my team would lose, he would sit up just to say something to me. So, oftentimes, you would see him sleeping in class or his head down in class. If he heard me walk in, he would say something like ‘Miss (Name of worker), the Bulls lost!’, and then put this head back down. But that was a little connection that we had with one another, and he didn’t have that with a lot of other people. So it encouraged me to continue to engage him.
Further cementing through difficulty
As the relationship continues to develop, so do challenges in the life of the one being helped. Every additional difficulty exposes the absence of supportive people, and surfaces the deep vulnerability that accompanies that absence.
These challenges are used to cement relationships in four ways. One, they are a test of the worker’s availability to help. Simply showing up matters a great deal for people who have learnt to deal with problems on their own.
Two, reaching out for help breaks the pattern of backing away. The helped knows she can come forward. That someone is there. Who will listen.
Three, by showing themselves at their lowest, when people have been robbed, when they have been abused, or when they are in hospital after an overdose, the connection with the worker is strengthened. These moments are emotional, and filled with desperation, the guard has to be down. It means the workers can find a way in.
Four, every challenge comes with the possibility for concrete help. It could be emotional help. At other times practical help. Getting accommodation. Dealing with bureaucracy. Providing a ride.
These challenges keep coming. And each is overcome. The relationship gets stronger and changes in nature. The asymmetry decreases and the reciprocity increases. The relationship begins to resemble a normal relationship.
Solid like a family relationship
Over time, the relationship between helper and helped is described as if it were personal, not professional. People in need of help refer to workers as mother, father, big brother, aunt or uncle. Workers describe the people they help as son or daughter. Even without these labels, they resemble family relationships.
It begins when workers become the first port of call when difficulty arises. All of us, from infancy to adulthood, organise our close ones hierarchically according to capability and availability to help. Once a solid ground has been established the helped do the same. They place their workers at the top of the tree.
A worker recalls when a young person called him:
He calls me. He’s like, “I’m at court.” I was like, “Okay. You should go and get checked in.” He said, “No. I think they’re going to arrest me.” He said, “I’m going to go on the run.” I said, “All right. If you’re going to go on the run, what’s going to happen?” We talked through the steps of going on the run. You could hear he had doubts. I was like, “Okay. You got to weigh out the options. What happens if you go on the run, and what happens if you turn yourself in?” It’s not like he was immediately convinced. But he didn’t run away. When I showed up at court. He was there.
The workers begin to be held in higher regard. They become people to look up to, mentors, role models; the features we look for in those who are closest to us, especially parental figures.
Just as parents do not give up on their children when they misbehave, so the workers’ commitment is not contingent. Workers expect, understand, and see the challenging behaviours — verbal abuse, disengagement, sabotage — as markers of progress. They recognise feelings of unworthiness and their influence on behaviour. So they don’t take it personally. They offer unconditional support, just as parents offer unconditional support.
There are limits. Challenging behaviours are challenged. But the workers judge the behaviour not the person. They point out the consequences of behaviour for development. And the pushback is not contingent. There is no penalty, other than further challenge of the challenging behaviour.
Despite the context, the bond between the workers and the people they help develops in day to day routine activities, eating together, having conversations about hobbies and interests, going to the Zoo, just as in close relationships. Finding difficulties that are shared. Resolving them together. Another feature of family relationships.
Violate professional boundaries but keep strong personal ethics
On the one hand, these are relationships between two people with different roles in the helping process. One can be called a professional, the other a client. On the other hand, over time, they look more like family relationships.
So what are the rules of behaving in these hybrid professional-personal relationships? Workers do not follow orthodox professional rules of conduct. In fact, they violate them.
Breaking the rules becomes a necessary condition for establishing the bond. Here are seven examples.
Broken rule 1: the context where help takes place
Relational workers do not have designated spaces where they see clients. (The physical space may exist but the workers do not treat it as inextricably linked to the work.) The worker goes to where the people they help hang out. They meet on the street, in the car, in jail, at the hostel, in the park. And every once in a while only at the place where the worker is based.
Broken rule 2: time spent relating
Time in these relationships is not framed by the timetable of a bureaucracy, nor is its length explained by a school of thought. It isn’t restricted, like therapy, to one-hour sessions. The timetable is framed around the changing lives of the helped.
Broken rule 3: disclosure
Workers talk about their personal lives. The professional term for this is ‘disclosure’. Therapists typically don’t disclose. It is not forbidden, it is a matter of professional discretion. For relational workers talking about one’s personal life is an opportunity to build common ground.
Broken rules 4 & 5: role of the helper and dual relationships
The roles of therapists or social workers are typically shaped by their professions built from evidence and accumulated clinical experience about behaviour, dysfunction, its causes, manifestation, sequelae and responses to intervention. The professional is trained in method and her practice is upheld via regular guidance. These roles come with certainty.
The role of a relational worker is not defined by a profession, and typically, the worker is not accountable to a formal code of ethics, and does not carry a portfolio of tested solutions.
Relational workers assume not one, but multiple roles. They are friends, advocates, mentors. Sometimes they are in loco parentis.
When therapists feel the relationship with their client starts to resemble a friendship, they withdraw. They seldom counsel family members. Their focus is the client. There are no ‘dual relationships’, to use the professional term. But for the relational worker, these are the norms.
Broken rule 6: Affection and physical contact
Getting near, physically and emotionally, in therapy is a no go area. Nurturing or expression of feelings towards clients are reasons for concern, and for supervision. People who relate to others faced with extremely challenging situations talk explicitly about the care or love for the people they help. They see it as central to the development of a family-like bond.
Broken rule 7: Digital boundaries
These days, therapists and other professionals are faced with the challenges of the internet blurring the private and public. How, for example, to respond to a client’s Facebook request? The relational worker uses all available communication — WhatsApp, Facebook, Snapchat. Anything to get a response, to keep the connection alive.
A series of orthodox rules are broken. There are few professional and bureaucratic constraints. So the relational worker must rely on strong personal ethics. They depend on virtue ethics. Being honest, reliable, loyal. Some are universal, not giving people money, not disclosing deeply intimate information. Others are relational, each response guided by the context and expectations of what ordinarily happens in healthy relationships.
Adapts to the context
The relational worker adapts to the context around those they help.
Sometimes this context shapes the relationship. Being in prison, in a hostel, or a treatment setting. The relational worker knows where to find the one she helps. They can demonstrate that they are still available. The person being helped cannot hide.
Opportunities for change also help. These can be crises that create the possibility for the worker to reach out; or it can be about practical needs, finding a place to live or getting a job, that direct the relationship, give the relational worker and the helped permission to connect.
Other contexts make engagement more difficult. When the cognition of the helped is muddled by mental ill health like schizophrenia or high anxiety or by misuse of drugs, the reach of the relational worker, and of the relationship is restricted.
