A very dear friend shared her deep concern for her sister, who is newly pregnant and probably experiencing some extreme hormonal shifts combined with pre-existing family issues leading her to deep depression. Her family has been working hard to nurture her, support her, provide gentle encouragement, and offer caring suggestions.
When supportive care may not be enough
The problem is that as time passes, her symptoms are getting worse; she is withdrawing more and more, and there are indications of fairly serious problems.
This is where I am so glad for the information Jean Illsley Clarke provides in her book, Growing Up Again, where she describes the differences between Supportive Care and Assertive Care. Both of these are forms of nurturing, whether it be for a child or an adult.
Supportive Care involves offering gentle invitations to nurture someone if that person would like to receive the care. The person has the option of saying, “No thank you, I’m fine,” or “I can handle this on my own.”
Assertive Care, on the other hand, is not about offering to be supportive. Rather, it involves being firm and definite so that the care being offered may not be refused.
Implicit is a decision on the part of the nurturer that the person needing to be nurtured also needs to be told directly what they must do. It needs to be made clear that the person is in need of a certain type of care and may not realize how important it is for that care to be provided.
Assertive care insists on a decision for action.
Some time ago I suffered a cold that was not only getting worse but, according to a friend who also happened to be a nurse, in which my cough was serious enough that I needed immediate medical care.
I thought I just needed some more time for my body to heal itself. However, she was not willing to let me make that decision and told me that I could either get in her car while she took me to the doctor or she would call an ambulance. It turned out to be a very good decision since I was quite ill with bronchitis and a touch of pneumonia and was in no condition to accurately assess my situation.
This is where my friend is right now.
She is deciding that her sister needs the family to make decisions she is incapable of making right now, decisions that are not only necessary for her health but also the health of her unborn child. She can then be clear and confident that whether her sister likes it or not, what she needs and deserves is more help than passively waiting for nature to somehow heal her.
Too, sometimes children need parents and caregivers to be assertive about their care. There are also times when it is okay to be supportive and give that child or adult the opportunity to accept or reject offered care.
It can be challenging but helpful to make a determination as to which type of care would be the most appropriate. At times, providing (and therefore not actually offering) Assertive Care could mean that the person will not be happy that someone is taking charge of their situation. However, real love is about knowing when to be assertive if someone is not able to recognize that he or she needs outside help.
Invitation to reflect:
1. Can you think of a time in your life when you needed and perhaps received Assertive Care from someone you trusted? What were some of your feelings about receiving this kind of care—resentment? Anger? At what point did you realize that you benefited from someone else insisting that you do or not do something and that the resulting care was really a form of them loving you?
2. Can you think of times when you have or maybe will need to be assertive when caring for a child or adult in your life? To what extent do you feel confident in your right and responsibility to stand up to their resistance, frustration or resentment and care for them assertively?
Diane Wagenhals, Director of Institute for Professional Education and Development, Lakeside Educational Network