Stories from strange places

The second of Steve Coulson's See Life Differently blog series.

This is a story demonstrating how you see things definitely depends on your perspective, and that some of the ways we have tried to create services for people with disabilities make it well-nigh impossible to see things differently enough to imagine the people we serve as citizens with a world of possibilities to offer their contributions.

Nearly twenty years ago I did quite a lot of training work in what used to be called Learning Disability (previously Mental Handicap) Hospitals. I found it fascinating and challenging and learned loads from the experiences I had. One of the exercises we often did with staff was to ask them to tell their story. In a room of twenty or so people we would ask who had been there the longest and then ask them to start to remember their earliest memories of starting to work there. We would then try to gradually invite everyone else to join the story telling chronologically, thereby building up a picture of the story of the hospital from the point of view of those in the room. It was a truly empathic way of beginning the work as it respected what was sometimes decades of experience of working in hospitals. However, it was often difficult to stay in listening in order to tray an understand mode as a variety of really extraordinary stories were told of how the place had worked over the years.

It was a difficult place to be as the external trainer trying to bring a message of the hope and possibility of working with people in the community. For example, the fact that often staff expressed a genuine concern that former patients who had left the hospital were homeless and destitute (or worse) because they never heard back from them once they had left – when there was much evidence to suggest that on ‘liberation’ from the hospital very few former patients would have had any wish to go back.

I will always remember the Nursing Assistant who interrupted me during one of the values-type exercises I was facilitating: “You don’t understand things from our point of view!” she challenged.

I asked her to elaborate.

“You’ve never worked in an institution”.

These sessions with staff in a hospital destined to close completely in the next year or so had been very difficult but I was getting used to these kinds of challenges being thrown at me and I thought I had a good riposte in this instance.

“Yes I have – in several actually,” was my bold assertion.

For a moment my adversary (for I am pretty sure she felt she was) hesitated and a glimmer of respect flashed across her eyes as she asked: “Which ones?”

I explained that in the early part of my career I had worked in lots of different children’s residential units in Edinburgh. I thought it was a fair point well made but she laughed somewhat mockingly as the confidence in her own line of reasoning apparently was vindicated: “Ah yes – but you haven’t worked in a HOSPITAL!”

She certainly had me there – apart from delivering these training courses and over the years visiting people resident there - I never had worked in a hospital. However, she seemed quite oblivious to the implication of this exchange. Yes, I may have failed to see things from her point of view and some of the others who worked in the hospital but then this was a positive thing. Almost certainly she was expressing in a crystal clear fashion how staff in institutions can be “institutionalised” in the same way (but with rather more power and influence) as patients.

Having listened to the stories of individual experiences I heard in the exercise I mentioned earlier, I did have some empathy for these nursing staff who found themselves after 10, 15 , 20 years of service in the place now at a point in its history when the policy makers were saying this is wrong, these hospitals must close. When we listened to the story of the place – almost to a man and woman, workers would describe their first days in the institution as if it were some kind of scene from Dante’s Inferno.

“Aw the noise was terrible”

“There were folk shouting and fighting”

“The smells”

“I was left on my own with 30 people”

“I had never seen so many people with disabilities in the one place”

“I was scared”

“I never thought I’d stay a day never mind a week – I’ve been here 25 years now”

I often thought if I had a £5 note for every time someone said something like that it would have boosted my income considerably. But I did wonder at the psychological processes that enabled people to cope with this trauma and at what cost in terms of themselves and the folk they served did they manage to insulate themselves and taken on a “world view” almost entirely internal to the workings of the hospital in order to survive?

The way in which we design the services for those citizens who require support to live lives of value and distinction, matters. If we see people as ‘social menaces’, ‘economic burdens’, ‘living lives not worth living’ or being somewhat ‘less’ than us in any way – then we will create institutions that warehouse and manage them and invariably diminish our ways of seeing them as contributing fellow citizens and of course diminish them. To live full lives people need to be not only ‘in’ but also connected ‘to’ their communities in a myriad of ways which enables us all to see life differently.



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Thistle Coach
Portrait of Steve Coulson

Steve leads on learning and development for staff at Thistle and also contributes to external training. He worked in local authority social work including residential child care, community work, supported living and with volunteers for 20 years. Steve was also a Social Work Practice teacher and has presented to university courses at Stirling and Edinburgh.

Steve has practiced and trained in person centred planning since 1999. He worked at Scottish Human Services as a Senior Trainer before joining Edinburgh Development Group in 2002 where he led the Future Plans project using person centred planning with young people in transition. He developed the Big Plan in Scotland with his friend Heather Simmons and they wrote the book ‘The Big Plan – a good life after school’ published by Inclusion Press in 2006. Steve has also contributed to a Jessica Kingsley Publication ‘Co-production and Personalisation in Social Care.’ He has worked throughout the UK, Western Australia, USA and Cyprus.

As well as developing and delivering Induction training and the Person Centred Principles into Practice course at Thistle, Steve regularly facilitates Big Plan sessions with young disabled people and their families as part of Thistle’s Interact project.

More articles by Steve

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