There is no ‘us and them’ by Stuart Sorensen

Stuart Sorensen

Stuart Sorensen

I began my nurse training with a very superficial mindset. I believed, without even thinking about it, that there were essentially two types of people in the world. There were ‘the mentally healthy’ and then there were ‘the mentally unhealthy’. I thought that the work of mental health services was to protect ‘the mentally unhealthy’ from themselves either by medication or by more social methods. I was glad to be one of ‘the healthy’: One of ‘us’.

Then, shortly after I qualified, I moved back to my home town and began to meet up with old friends – many of whom I hadn’t seen for years. Around half a dozen of us met up for a meal in a local pub. We had a good time swapping stories of our schooldays and catching up on the events of the intervening years. That was when it first began to become clear to me that there really is no ‘us and them’.

Of the six of us sat around that pub table five were (or had been) taking anti-depressants. Every single one of my old friends had been prescribed pills to make them feel better. But they were my old mates. They were my best friends. They definitely weren’t to be considered as ‘them’.

That was the beginning of a mental journey that led me to rethink my old assumptions about mental health and illness. I needed to work out what was different between my old school friends and me. It surely wasn’t simple biology as I’d been taught. They couldn’t all have ‘the depression gene’ (whatever that is).
Finally it dawned on me. The difference isn’t just biology, although that can have a part to play. Biology is not the complete answer. It’s not the complete answer by a very long way. Attitude, social situation, environment and general coping style are just as important – arguably very much more so. This matters.

Once we acknowledge the impact of social skills, environment, opportunity, coping methods and psychological style we begin to see that given the right life chances people can be far more than they might appear. Our own assumptions about ‘them’ keep people from overcoming their problems by limiting those opportunities. It’s truly amazing what people can do when we treat them like ‘us’.

There really is no such thing as ‘us and them’. People are just people and they do the best they can with what they’ve got.

“Take your pick”

Imagine a small child in a very large sweetshop. The lights are off and it’s completely dark except for a single spotlight illuminating a tiny piece of shelving. On the shelf, visible in the little pool of light are three bars of chocolate. One bar is milk chocolate, another dark while the third is white chocolate. That is all the child can see. The child has one simple instruction… “Take your pick”.

Obviously the child will choose one of the three chocolate bars he can see. It doesn’t matter what other treats might be in the shop because he can’t see them – he doesn’t know that they are available options.
This little article isn’t really about chocolate bars and children in sweetshops though. It’s about social care service users and the options they have available. The sweets in the shop represent resources and coping strategies. Just like the child in the sweetshop service users (along with everybody else) only choose the options, the behaviours that they know about.

So if someone you work with makes poor choices that’s not necessarily because they don’t want to do better. It’s more likely because they either don’t know what else to do or because they don’t think that other options will work for them. Many people understand intellectually about good coping skills, socially acceptable behaviours but don’t believe that they will be given the opportunity to make different choices work for them. If they’re used to being treated with mistrust they won’t believe that the truth will work for them. If they’re used to being ignored they won’t believe that not drawing attention to themselves will meet their need for human contact. And they may well be right. They do the best they can with what they’ve got. And coping skills develop slowly for all of us. There is no ‘us and them’.

Take a moment to think of all the things that you’re most proud of in your life….

For some that might mean professional qualifications from NVQs or VQs to diplomas, degrees and even PhDs. Others will think of less formal achievements like charitable endeavours or learning to play a musical instrument. Perhaps you’re good at a particular sport or maybe you’re proud of overcoming your fear of heights and going on a parachute jump. It takes a particular form of courage to jump out of a perfectly good aeroplane several thousand feet above the ground. A friend of mine recently climbed Kilimanjaro. He’s rightfully proud of that. What have you achieved?

The fact that you’re able to read this blog at all means that you’ve achieved something that most humans throughout history never managed to do. You have learned to read! Whatever you’re thinking about the chances are that the things you’re most proud of didn’t come easily. They took effort. They took mistakes.
Thomas Eddison reputedly failed thousands of times before he successfully invented the light bulb. His attitude to these mistakes was interesting. He didn’t see them as failures. He saw them as learning opportunities. He saw them as milestones along the road to success.

Every time he built a bulb that wouldn’t light up he learned a little bit more about how not to make a light bulb. Inevitably all that knowledge, all that trial and error eventually led him to find the right way to generate light.

Eddison learned from his mistakes just as you have learned from yours. Writing the first assignment you submitted in that college course, your first fumbling attempts at making music, the first time you tried to hit a cricket ball or ride a horse you made mistakes. Over time you learned from these mistakes and you did better. That’s as true for you as it is for your service users. They make mistakes too. And when those mistakes are handled correctly they learn from them – just like you do. There is no ‘us and them’.
So the next time your service user gets something wrong or fails to meet expectations don’t assume they’re incapable. Help them to grow because of that mistake, not in spite of it. It’s a vital part of learning new skills and new ways of coping.

Even with practice people rarely achieve perfection. It’s true that we might perform faultlessly some of the time but even the best of us gets things wrong on occasion. For most of us it’s a very regular occurrence no matter how much we’ve practiced. We all have ‘off days’ and we all make mistakes. There is no ‘us and them’.

“Nobody’s perfect” as the saying goes.

But whilst it’s easy to excuse ourselves for the regular little errors that make up every day of our lives many workers in health and social care sometimes have difficulty extending the same understanding and forgiveness to service users. The next time you go into work take a random batch of care or support case files and look at the care plans inside. See how many of them have been discontinued as ‘unattainable’ after only one or two attempts. Notice also how many have stated goals set far too low because of an assumption that since the service user didn’t get it right every time they cannot be expected to attain meaningful goals. Then apply the same logic to your own life.

Would you find your own support plans discontinued if the same stringent demands were applied to your….

• Sobriety
• Spending and budget management
• Anger management
• Compliance with medication regimes as ‘self-administrator of meds’
• Smoking cessation (how many times did the ex smokers you know try and fail to stop before they succeeded?)

The fact that you screw up from time to time doesn’t make you a failure. It merely makes you human and fallible. We all make mistakes but that doesn’t mean we are incapable of doing well too. If we allow ourselves to be less than perfect then we must also allow the same freedom to be fallible for our service users.

There is no ‘us and them’.

Stuart Sorensen is a mental health nurse, trainer and speaker. He is founder and editor of Care To Share Magazine. See Stuart’s website and blog at


4 thoughts on “There is no ‘us and them’ by Stuart Sorensen

  1. I shall send this blog in the direction of my care coordinator! About 12 months ago I was discharged from the mental health team. ‘You haven’t made any measurable improvement in the last year. We only give short episodes of treatment’. I felt flattened, I had been trying very hard to get on the road to recovery and in a moment of assertiveness wrote and sent a list of things I had achieved (against all odds – getting out of bed was an achievement sometimes) here’s a sample of what was on that list (14 items on it)

    – dealt with the large tree that fell down in my garden and out of the devastation caused planted new trees, a wildflower meadow and a 40 foot native hedgerow
    – bought a newer car – it is always difficult for me to buy anything new as I never feel I will be around to use it – always assuming will be dead soon
    – did a 10 minute live radio interview on local radio about depression/suicide on Suicide Prevention Day
    – investigated several volunteer opportunities and had a couple of interviews but some charities never returned the call

    Oh they said we forgot about those you did achieve quite a lot last year. I had been left feeling ‘not good enough’. They had set the bar too high I was supposed to be better in 12 months after 9 years of being mentally unwell. Yes I do voluntary work now but it took several goes to get there and find the right position no one was prepared to support me in trying and trying again.

    I’m still far from well and I did finally regain my support (with a written apology that they had exacerbated my mental health problems – thanks a bundle) but I am a little further on than before. If I had psychical problems like the old broken leg analogy I wouldn’t be expected to run a marathon straight away. I like your message of ‘be realistic’.

    • Hi J,

      Thanks for your comment. It always means a lot to get positive comments from people using services. It encourages me that my writing is ‘on the right lines’.

      It sounds as though you’re pretty active yourself in the public awareness arena. Let me know if you’d like to contribute an article to Care To Share yourself at any time. Authors’ guidelines are at the top of the blog’s home page.



      • Stuart. I did actually send you an article a while back but it was a bit controversial and I finally withdrew it in case it attracted negative comments. Yes I do try and get my experiences out there to promote better understanding of m h issues. I find it keeps me going. That first radio interview was a huge achievement for this shy back row in the corner person – never thought I could do that sort of thing and I’ve gone on to do 5 more radio/tv/internet interviews and a short film + 2 articles. You never know til you try eh.

      • Oh yes. I remember. Sorry I didn’t make the connection sooner.

        Keep up the good work 🙂

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