‘Psychologically informed relationships make the world go around’…

07.11.2022: Writing this week’s PIE blog*, as the lead for Psychologically Informed Environments (PIE), at the national youth homeless charity; Centrepoint, I have been reflecting on a varied week but what has been at the heart of it all, as per a PIE, has been the importance of ‘relationships’. One of the highlights of this week was the launch on Monday of our new PIE informed ‘Effective Keyworker’ training that I had the pleasure of supporting Adelle Berman (PIE Trainer) to deliver to our first frontline staff group at our Head Office. This training focuses on how staff can build effective psychologically informed effective relationships with the homeless young people that we support in Centrepoint, but many of the concepts and information covered is arguably just as important when we are building effective psychologically informed relationships with anyone, including our colleagues and for that reason, I am going to focus on this further for this week’s blog.

Effective psychologically informed key working or relationship building with others is critical in a PIE — relationships are the ‘bread and butter’ of any work that involves ‘people’. As Keats et al (2012) note in their good practice guide; ‘a focus on managing relationships is perhaps at the heart of what makes a psychologically informed environment different. In this model, relationships are seen as a principal tool for change, and every interaction between staff and clients is an opportunity for development and learning’ (p.24). Moreover, relationships are arguably the ‘everyday magic … key to mental health and resilience’ (Cockersell, 2018). On this latter point, I have previously written specifically about the healing power of relationships in a past PIE blog (c.f. https://medium.com/@drhelenmiles/healing-or-harming-harnessing-the-positive-power-of-relationships-in-a-psychologically-8cbd32d0424c).

Consequently, if relationships are so important; what do we need to bear in mind when trying to build or development them with others, whether that is the homeless young people we support or the colleagues we are working alongside? Luckily, there is plenty of psychological theories and evidence to draw upon to generate ideas that are applicable to all of us, whether in our professional relationships or even our personal relationships too.

Any starting point in building a relationship with another person has to be an awareness of equality, diversity and inclusion — in other words being ‘culturally sensitive’. I have written a previous blog on inclusion in the workplace, as part of National Inclusion Week (see here: https://medium.com/@drhelenmiles/are-we-inclusive-a-psychologically-informed-perspective-on-national-inclusion-week-bfc0a3063519), although as a quick reminder, ‘Equality’ is about ensuring everybody has an equal opportunity, and is not treated differently or discriminated against because of their characteristics. ‘Diversity’ is about taking account of the differences between people and groups, and placing a positive value on those differences, and ‘Inclusion’ is about creating a collaborative, supportive and respective environment that increases the participation and contribution of all those within it.

Why does this cultural sensitivity matter in building relationships? Well not everyone we need to work with (or meet outside of work) is the same as us. We all have different life experiences, cultural backgrounds, attitudes and beliefs. In fact, that is what is so wonderful about the world (and very interesting to me as a psychologist!) — wouldn’t it be boring if everyone thought, felt and acted the same as us? This means language, behaviours and customs can vary between individuals and being aware of this difference (and celebrating it rather than being anxious about it), can help us to form relationships / connections to others. I am a white working class female psychologist, which means when I meet another person who might appear different from me I won’t necessarily have the same perspective as them on many different things. However, if we both approach each other with curiosity, interest, respect and appreciation, rather than anxiety or assumptions, then we can connect and build a relationship. This relationship can be mutually beneficial to us both as we learn from each other and broaden our views, enabling us to work together. As noted in the quote by Audre Lourde — “it is not our differences that divide us. It is our inability to recognise, accept and celebrate those differences”. Moreover, in my experience if we take the time with another person, we often find that we have more in common than we are different.

Humanistic Psychologists such as Carl Rogers (1951), who developed person-centred counselling approaches, have also argued that key to building relationships are some core skills that are encouraged in all therapists in order to build therapeutic working relationships that bring about change. Whilst we do not have to all be therapists (!). I think these concepts are critical in building psychologically informed relationships with anyone we meet in whatever context. The first and most important of these is ‘Empathy’. This is so important that I have written a previous PIE blog on this topic alone (see here: https://medium.com/@drhelenmiles/a-key-piece-of-the-jigsaw-the-importance-of-empathy-in-a-psychologically-informed-environment-e88c1b8a5f97), but in brief empathy is the ability to understand and share the feelings of another, without taking it on as your own. It is not feeling sorry for someone (i.e. sympathy), but rather the process of trying to ‘walk in their shoes’ to understand what is going on for the other person in that moment.

Therefore, displaying empathy means communicating to the other person that whilst we might not have had that exact experience, we can relate to the feelings they are experiencing (e.g. sadness, fear, guilt), which after all are common feelings we all experience from time to time. As the psychologist, Brené Brown often states; ‘empathy drives connection’ to others as we are letting the other person know we ‘get them’ thus strengthening our relationship with them. It means trying to imagine how they might be feeling in that moment, by really listening to what they are saying (not what we think they are saying), which in turn can help us to see things from their perspective.

Rogers (1951) also argues that building therapeutic (or any other) relationships with another person involves approaching them with ‘unconditional positive regard and non-judgement’. In other words, accepting the person as they are, rather than perhaps how you might like them to be. This means when engaging with another person, we focus on listening to what they are actually saying (i.e. not jumping to conclusions) and creating an accepting space wherein the other person is able to talk freely and comfortably with us without fearing that they are being judged. This is actually quite hard, as human beings are programmed to make judgements about any stimuli around us to avoid being overloaded by the vast array of information perceived at any one time! However, Rogers (1980) notes that ‘to be with another in this way means that for the time being, you lay aside your own views and values in order to enter another’s world without prejudice’.

A further person-centred skill in building relationships is ‘congruence’ — the ability to be real and genuine within our interactions with another person, which of course requires a self-awareness of our own thoughts, feelings and behaviours. Lots of our frontline staff often remark to me in reflective practice sessions that the homeless young people they support are really good at spotting when someone does not really care or is not really interested in them (often because they have experienced this disinterest or rejection from others in the past). Young people are also very good at spotting if someone is being ‘fake’ and this can lead to them disengaging. Being our authentic selves (within professional boundaries) with the homeless young people we support (as well as the staff we work with) is therefore really important to build meaningful positive relationships and of course trust (see the previous PIE blog on the importance of trust in building psychologically informed relationships here: https://medium.com/@drhelenmiles/trust-the-key-to-building-psychologically-informed-relationships-215777213308).

Other areas to consider in building relationships, highlighted by psychologists, include communication and honesty. As Keats et al (2012) note, in a PIE approach; ‘to keep a group healthy, the ‘difficult conversations’ should not be avoided, but discussed openly’ (p.24). Sometimes, this might be in a 1:1 key-work or supervision session, sometimes this might be in a safe team space such as a reflective practice session. Keats and colleagues go on to note that ‘honesty is a crucial part of any sustaining and therapeutic relationship, and in all honest relationships there will sometimes be disagreements: these should be aired, and a negotiated position achieved’ (p.24–25). Of course, that is not always as easy as it sounds, and can be emotionally difficult but I would argue that avoiding the difficult conversations is far worse, as this can lead to the build-up of resentment and can quickly make relationships toxic and/or unhelpful. The importance of psychologically informed communication, and how to do this, is also an area that I have previously written about in a PIE blog (see here: https://medium.com/@drhelenmiles/he-said-she-said-creating-psychologically-informed-communication-to-build-positive-5b80e9c9a3e6).

It can also be helpful to adopt a strength based or positive approach to our relationships. If we approach another person thinking that the interaction will be negative or focus solely on the problems, then the relationship will sap our energy and we can feel less motivated to engage with that person in the future. Relationships with others are hopefully something we find positive, and within many of our relationships, there is a place for ‘fun’ and ‘joy’. Shared humour and laughter can create a powerful bond between us, and even when working in the homeless sector, I hope that we can create space for this despite the challenges we might be facing on a daily basis.

Obviously we might not ‘like’ everyone we meet or work with (that is normal!), so when building relationships with someone we might struggle to connect with immediately, it can help to step back and reflect is there one thing that we can ‘like’ about them; however small? This means our interaction with them starts from a positive place, rather than a negative one. I certainly have found this perspective helpful in the past when working with offenders, particularly those who have committed often quite heinous crimes. Separating the person from their past behaviour, and looking for their strengths or aspects about them that I can connect with, has meant it has been easier to build a therapeutic relationship with them and enable us to undertake positive work together to bring about change as needed.

In summary, when building psychologically informed relationships with others, whether the homeless young people we are supporting in Centrepoint, our colleagues we are working with within the organisation, or even outside of work in our personal relationships, we can do this more effectively, if we try to remember and action some of the above points. A lot of these can be captured in the acronym ‘PACE’ — devised by the psychologist Dan Hughes. PACE stands for PLAYFULNESS, ACCEPTANCE, CURIOSITY and EMPATHY, four key ingredients of any psychologically informed relationship. Given that relationships are at the heart of any PIE approach this is an area that we need to continue to focus upon improving in our PIE journey at Centrepoint. Therefore, for readers of this blog, perhaps take a moment to reflect on what of the above we are doing well, what we perhaps need to do more of, and finally perhaps what we had not considered and so need to start doing in our relationships with others. Are we at least being PACE? If not, why not and what do we need to work on a bit more in the future to build psychologically informed relationships with the homeless young people we support or the staff we work alongside?

One final thought — relationships with others can be difficult. Other people do not always want to do what we want them to do. Sometimes we have conflict with others. No one gets it right all the time — I certainly do not! However, as our CEO at Centrepoint, Seyi Obakin commented to me this week — it is important that we ‘seek to understand others, before we seek to be understood’. If we can all be willing to reflect upon our relationships with others, and think about why the other person is saying or doing what they are before we respond, we can hopefully build a more psychologically informed and positive professional or personal relationships with them. After all, humans are social creatures and therefore relationships really do ‘make the world go around…’

* with thanks to Adelle Berman (PIE Trainer), for some of the content of this blog, which is taken from the new Centrepoint PIE informed ‘Effective Key-working’ training.