Critical Values Based Practice Network

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An Alternative to Challenging Unusual Beliefs

Written by Steven Coles on . Posted in Clinical Psychology Bite-Size

An Alternative to Challenging Unusual Beliefs

Issue 29 – November 2011

Author: Steven Coles (steven.coles@nottshc.nhs.uk)

Key points

  • Beliefs deemed unusual hold some form of meaning and function for people
  • We all hold beliefs that cannot be proven or that parts of society might disagree with
  • Challenging a person’s beliefs carries the risk of leaving a someone feeling criticised, shamed and could lead to disengagement from services 

Implications for practice

  • Rather than challenging beliefs deemed unusual, they could be accepted and worked with. A person could be supported from their perspective of reality.
  • It might be helpful to focus on what people do and how they relate to others, rather than on what they believe
  • This approach still requires reflection on ethical dilemmas  
Previous bite-size articles have highlighted that beliefs that are deemed unusual or delusional either by society or professionals, hold some form of meaning and function for a person and are shaped by people’s lives and social world1,2. Given this, whether or not these beliefs are deemed to be grounded in reality by staff or society, such beliefs need to be treated respectfully and seen as an important part of how the person views their life and world. Furthermore, many beliefs we all hold (such as political convictions, religious beliefs etc) cannot be proven and many may disagree with them, however, such beliefs are still important to us and give meaning to our lives. Challenging anyone’s beliefs can leave them feeling criticised, ashamed and alienated; this will be particularly the case for people who have already experienced traumatic and shameful experiences in their lives3. Even those working from a cognitive behavioural approach have questioned the need and utility of challenging thoughts. Harper (2004)4 highlights that rather than focussing on the truth or not of a person’s beliefs we should instead “focus on the fit between a person’s beliefs and the life they wish to lead” (p. 60). By definition an unusual belief might not overlap with wider cultural beliefs, but the interesting question is how does the person navigate and live their life within this wider context. Navigation and negotiation will be harder in some areas of life than others; for example a person with religious beliefs will perhaps struggle at a secular society meeting, but find a warmer welcome within some religious and spiritual communities. Knight (2009)5 has written a guide (free to download at: www.peter-lehmann-publishing.com/beyond-belief.htm) for those working with people who hold beliefs that are deemed unusual. The guide comes from the perspective of “accepting the individual’s beliefs, experiences and reality – however bizarre or delusional the person trying to help might view them to be, and then assisting the person seeking help to cope with things as they perceive them to be.” The guide is based on qualitative research looking at how people with and without mental health issues cope with problems in their lives. The starting point to working in this manner is simply listening, respecting and being genuinely curious about a person’s experiences and view of reality. We do not personally have to share someone’s beliefs, but it is important to try to have empathy and understanding of a person’s view of the world. We can then try to help the person from their viewpoint. The following is grounded in the ideas and techniques from the guide – the prompts are written to help service users reflect on possible ways to deal with their issues.
  • Strategies to reduce fear and increase control
Are there ways I can make the situation safer? What control or influence do I have over the situation? 
  • Protection strategies
Are there ways to protect myself – practically, emotionally or spiritually?
  • Take a break
Can I get away from the difficult situation – take a holiday, go to a bed and breakfast? 
  • Predicting and planning for difficult situations
What can I do to make myself safer and more in control in this situation?
  • Looking at the problem from different angles
Am I jumping to conclusions? Is this particular situation as risky as I think it is? 
  • Turning the situation around
Are there any positives to the situation? Am I being protected? 
  • Talk and Support
Are there people I can talk to about the situation? Are there people who can support me – socially, practically or emotionally? 
  • Learning and Growth
What have I learnt from the difficult situation? How have I developed positively from these experiences? 
  • Feeling Stronger in other Areas
Having more resources in my life (e.g. friendships, hobbies) may help me feel better able to deal with the problem. If I have a structure and activities in my day it may take my mind off difficult areas of my life. 
  • Meditation, Prayer, Spiritual Sources of Help
If you are a religious or spiritual person, you could consider spiritual forms of support. 
  • Problem Solving
Try thinking of as many solutions to the problem as possible; what are the advantages and disadvantages of each? Pick the best one, try it out. What is the problem getting in the way of me doing? Are there ways to achieve what I want, by going around the problem? 
  • Problem Behaviours
Am I doing anything to make the problem worse? Am I doing anything in reaction to the problem that makes life harder for others or myself?  This approach still entails ethical dilemmas (see Houghton, 2011, for a discussion of ethics in clinical practice), for example what if a person’s belief is related to risk to themselves or others? The above way of working though highlights what a person does and how they relate to others, rather than what they believe. This perspective can encourage a flexible and creative way of working with beliefs deemed unusual. As staff, we should reflect upon our own beliefs, and consider whether what is currently culturally considered normal is actually the best of all possible worlds.

REFERENCES

  1. Collinson, C. (2008). Understanding ‘Delusions’. Clinical Psychology Bite-Size, 5 (August, 2008)
  2. Coles, S. & Cromby, J. (2009). Making sense of paranoia. Clinical Psychology Bite-Size, 17, (August 2009)
  3. Gilbert, P. (1998). What is shame? Some core issues and controversies. In P. Gilbert and B. Andrews (Eds.). Shame. New York: Oxford University Press
  4. Harper, D. (2004). Delusions and discourse: Moving beyond the constraints of the modernist paradigm. Philosophy, Psychiatry & Psychology, 11, 55 – 64.
  5. Knight, T. (2009). Beyond belief. Berlin: Peter Lehman Publishing
  6. Houghton, P. (2011). Ethics in clinical practice. Clinical Psychology Bite-Size, 28 (July, 2011)
 

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