Issue link: https://www.ascpskindeepdigital.com/i/1489006
78 ASCP Skin Deep Winter 2023 How do you address their concerns without causing additional harm? Harm reduction in client engagements can be organized into four seemingly simple, but hard-to-implement tenets. • Minimize judgment • Avoid offering advice or opinions • Respect autonomy • Understand the complicated nature of behavior change Chances are good that you feel confident you already do at least the first three because you imagine yourself to be a caring person. And chances are good that you are, indeed, a caring person. Ironically, it is exactly this caring nature that makes you particularly likely to trample right through the first three and to have a limited understanding of how and why the fourth piece about behavior change is relevant to this conversation at all. It seems simple. But people are never simple. Minimize Judgment So, what does it mean to minimize judgment? First, we have to unpack the word judgment. Nobody likes to be judged. When we have been or are being judged, it's a uniquely uncomfortable feeling that undermines our ability to trust the person who is judging us, and often that judgment even turns us on ourselves. Most of us know this feeling, and because we know it, we feel confident that we wouldn't do it to another person; certainly not to a person who is paying us to be good to them. Keep in mind that leaping to a conclusion in your mind as a person describes their symptoms is judgment. It's leaping before looking. It's jumping to make this person like others you have worked with. When you decide that a person will always have a certain type of skin condition because they have what you consider poor sleeping habits, that's judgment too. Minimizing judgment requires that we own that we are wired to judge. It's what our minds do. It's so automatic that we don't notice we're doing it. We think we're simply seeing the world the way it is. We miss the fact that the way we see the world is not truth. It's perspective and it distorts our ability to see the world of others with clear eyes. The moment a client enters our space, we are judging them. Their clothes, their apparent "health," the way they talk or walk. (I'm not talking about assessment, friends. I'm talking to you about a thing every human does.) We are trying to make sense of them. We think we are wondering, "Who is this person?" We are actually and imperceptibly thinking, "What type of person is this? What boxes and categories do I already know and feel I understand that I can apply here?" It will do no good to pretend this isn't happening inside you. In fact, pat yourself on the cognitive back if you judge people. It means your brain is working the way it was designed. And while it's "normal" for our brains to do this, meaningful client relationship demands that we choose to notice this and interact differently with it. We must begin to say to ourselves, "This person's clothes smell like cigarettes. I notice that I hate that smell. I know that I think people who smoke don't care about their health. How will that challenge my ability to interact with this person from a place of openness and curiosity so that I can really hear what has brought them to me for care?" You are unlikely to train yourself to stop judging others altogether, but it is absolutely within your grasp to notice that pattern and soften it, slow it, and redirect it to facilitate greater awareness and deeper connection. Avoid Offering Advice or Opinions Let's talk about offering advice and opinions. This is yet another invitation to be honest with ourselves. When we offer advice and opinions, we do it for a variety of reasons. We want to help. We want to feel smart. We think we have good ideas that will support our clients' "progress." We are afraid to say, "I don't know." There are certainly more reasons, and you may have your own that are not mentioned here. Regardless of your motivation, the harm that is unwittingly wrought by It can be easy to forget when you have given hundreds of treatments that the "basic" questions you ask your clients are inherently sensitive because their bodies and skin are not typically a topic of discussion with others—and possibly not even with themselves.