It's Not Really About You: How to survive aggression from clients in social work

How to survive in social work

When dealing with hostile and aggressive people you should not take it personally, advises the blogger Masked AMHP

Guardian, June 14, 2013.

A few days ago, one of our CMHT nurses returned to base in tears. She had been visiting one of her patients, a woman with bipolar affective disorder. She knew she was relapsing, and had been trying to support her and her relatives, and had been striving to avoid a hospital admission for several days.

The patient had shouted at her. She hurled very personal insults at her. She berated her for failing in her job, for letting her down, for not being a good enough nurse. It hit a nerve with my colleague. It triggered her deepest fears. Was she a bad nurse? Was she incompetent? Could she have done more to prevent this crisis? Was she so useless? Should she hand her notice in right away?

The team did their best to support and comfort her. She was a good enough nurse. She had done her best. She had seen a relapse coming, and she had done everything she professionally could to avert it.

This incident made me think about how mental health and other care professionals survive the job. It made me think about how I had managed to continue to function as a (hopefully) effective social worker for over 37 years.

I remembered very early on in my social work career being given a particular female client to work with. She and her children were very well known to services, and had had many social workers. I was the latest.

I walked into her living room and introduced myself. She took a deep breath and then proceeded to treat me to a tirade of complaints and insults which continued for at least 30 minutes. Throughout this deluge of vituperation I stood silently and listened diligently. At first, I was mortified. Judging by her comments, I must be the very worst and most totally useless social worker in the entire world.

But after a while, it occurred to me that all this had nothing to do with me. She was ventilating. She was expressing her anger and despair at the system, and at the world in general. I just happened to be there at the time. It wasn't personal. It wasn't about me at all.

I learned right then that it was all about separating out the professional persona and the professional functions from the personal, from the individual me. When I realised this, I suddenly felt a lot better. I waited patiently for her to finish, then got on with the job in hand. She never shouted at me again.

It's a simple lesson, but not necessarily easy to learn. But it has helped me to deal with the often hostile and verbally aggressive people who I have to assess under the Mental Health Act.

It has even helped me to remain mentally intact on the few occasions when I have been physically assaulted during the course of my work. It's not actually about me.

Social work students, having witnessed me working in extremely fraught and stressful situations when acting as an approved mental health professional, have often asked me how I manage to remain calm and unflustered when they have been mentally (and sometimes physically) cowering. I tell them that story. It's all about separation.

The Masked AMHP blogs at themaskedamhp.blogspot.co.uk

If you would like to blog for the social care network about issues affecting social workers' professional lives, then you can get in touch by emailing us at socialcare@guardian.co.uk.