Milton Erickson was an American psychiatrist who is highly regarded in certain circles. I didn’t know what to make of him – he is best known for his work in hypnosis – and so I wanted to have a look at his work for myself. Luckily, there are a few videos of him. While I don’t necessarily subscribe to his theories and explanations, he does seem to have a lot of insight into human behaviour. He recounts a story of a colleague, a psychiatrist who demonstrated avoidant behaviour in his personal and professional life. Erickson had numerous opportunities to intervene, but in the video he declares that he didn’t have the right. Among doctors, there is a doctrine that unless you are asked, you generally don’t intervene. Obviously, we don’t wait for a patient to point out gaping wounds and pools of blood – we intervene. As a spotty teenager coming in for bronchitis, I’ve left the GPs office many times with advice to drink plenty of fluids and sleep – but no word about the spots, though she hardly missed them. You get the gist.
I always wondered about the concept of having a right to help someone. Not just in a medical context. If you are in the supermarket and you see a woman who’s skirt is tucked into her tights, do you tell her? Or is it not your place? If your friend is stuck in a toxic relationship or getting too accustomed to alcohol – do you interfere or is in the their family’s job?
Inevitably, it is difficult to be the one to call the bad news out. The person whom you are trying to help will resent having their issues pointed out – even if you are as supportive as can be. Some people may even see this as a form of confrontation. I think culture play a role. The level of insecurity of the person in question is also important. However, it seems to me that if you want to be helpful, certainly if you call someone your friend, it is an ethical obligation to help.
This doesn’t mean they have to change, or even accept your point of view. Maybe, Erickson’s friend wouldn’t have wanted to hear about it and, filled with resentment, would never have spoken to Erickson again. Maybe, teenage me would have felt that the GP was being horrible criticising how I look. However, I feel there’s something genuine about being more open. I think in truth the main motivation to not volunteer to help is fear of resentment – not respect for autonomy. People opt for superficial relationships rather than a gamble between a deeper relationship or drifting apart.
I feel that it takes tremendous courage for someone to ask for help. This is another reason why I err on the side of reaching out first. I am sure many teenagers wish that somebody would just tell them that their acne needs to be treated. I am sure many people who are abusing alcohol, self-harming or losing too much weight will never ask for help – but are silently screaming for it. I am still in touch with a beloved former teacher of mine. She will never go to the doctor – she subtly explained that her blood pressure is all over the place. Is that enough to have the right to help? I jumped at it.
It’s a risky strategy, and you will surely lose some friends over it. At least, you will always know that you were a friend.