Social Ranking Model of Distress
Social Ranking Model of Distress
Issue 14 – May 2009Author: Steven Coles (firstname.lastname@example.org)
- Social ranking theory emphasises the importance of social relationships to our well-being
- People who are unable to escape difficult circumstances (e.g. domestic violence, difficult neighbourhoods etc) are likely to be distressed (including feeling ‘depressed’)
- Difficulties in a person’s early environment can also lead to a person having low self-worth
Implications for Practice
- Staff could help service users map the positive and negative resources in their life and support them in attempts (often in difficult circumstances) to make changes in their world
- It would be useful for staff to reflect on how mental health services as well as being helpful, can also be coercive and therefore a potential source of difficulty in someone’s life
Sources of DefeatGilbert (2000)4 has proposed that there are three main types and sources of defeat: (1) External attack or social putdown: This might include obvious or more subtle forms, including bullying, discrimination, harassment, domestic violence, living in an area of high crime etc. (2) Lack or loss of resources: such as poor housing, unemployment, lack of education, few social contacts, financial insecurity etc. (3) Internal sources of attack: such as self-critical thoughts, or powerful and malevolent voices. These internal sources of attack are also likely to have been shaped by a person’s life history and social world. Social inequality has also been shown to lead to more ‘unhealthy’ societies (e.g. increase violence, worse physical health etc.). Similar to social ranking theory, Wilkinson (2005)5 argues that inequality affects the quality of social relations, which in turn has a strong impact on stress and health.
Importance of Personal History6The theory also emphasizes the importance of a person’s life history to their sense of self-worth and how alert they are to potential threat and harm. For example if someone is brought up in an environment that is abusive and / or neglectful it will be adaptive for a child to be prepared for threat and defence, and to feel they need to compete for their social place and resources. Alternatively if someone is brought up in a safe and caring environment they are more likely to have a more compassionate view of themselves and feel more secure in their social standing and worth. Clinical Implications Social ranking theory highlights that what happens in a person’s world (e.g. relationships, housing etc) has an important influence on their well-being and level of distress. Hagan and Smail (1997)7 have produced a helpful template for mapping the positive and negative resources in a person’s world in terms of: home and family life, social resources, personal resources and material resources. These resources (or lack of) are influential to mental health. The map of resources can help guide services users (and supporting staff) to consider the potential for positive changes in their life. If these changes are achievable, they are likely to benefit a person’s psychological wellbeing. However, such changes are often difficult and complicated to accomplish. Social ranking theory has also been applied to expand the scope of approaches such as Cognitive Behavioural Therapy (CBT). An advantage of applying this theory to CBT is that it highlights the importance of a person’s social world that can be sometimes missing in CBT approaches. Further, it highlights that ‘cognitive distortions’ or ‘dysfunctions’ are perhaps best considered as adaptations and reflections of life circumstances8. Mental health services can be helpful to someone when they suffer defeat and low status, however, services can also be sources of defeat and entrapment. For example, being detained in hospital under the mental health act (against a person’s wishes) is likely to be experienced as feeling trapped. Similar points can also be made regarding the enforcement of psychiatric drugs. Further, a person being labelled with a stigmatised diagnosis such as “schizophrenia” is likely to be damaging to a person’s self-worth. It seems important for staff to reflect on how services can be both helpful and detrimental to a person’s self-worth, so to try to minimise where possible services more coercive practices. Social ranking theory highlights that we can all have the potential under certain circumstances to feel defeated by life and to feel distressed, with some of us being more fortunate in our circumstances than others. The theory highlights that the outside world shapes our internal world and personal well-being, and therefore we should look outwards when supporting someone who is distressed.
- Gilbert, P. (1992). Depression: The evolution of powerlessness. Hove: Lawrence Erlbaum Associates
- Pilgrim, D. & Bentall, R. (1999). The medicalisation of misery: A critical realist analysis of the concept of depression. Journal of Mental Health, 8, 261 – 274.
- Gilbert, P. & Allan, S. (1998). The role of defeat and entrapment (arrested flight) in depression: A exploration of an evolutionary view. Psychological Medicine, 28, 585 – 598.
- Gilbert, P. (2000). Varieties of submissive behavior as forms of social defense: Their evolution and role in depression. In L. Sloman and P. Gilbert, Subordination and defeat: An evolutionary approach to mood disorders and their therapy (pp. 3 – 45). London: LEA.
- Wilkinson, R. G. (2005). The impact of inequality: How to make sick societies healthier. London: Routledge.
- Gilbert. P. (2005). Compassion and Cruelty: A Biopsychosocial Approach. In P. Gilbert (ed). Compassion: Conceptualisations, Research and Use in Psychotherapy. (p. 3 – 74). London: Routledge.
- Hagan, T. & Smail, D. (1997) Power-mapping – I. Background and basic methodology. Journal of Community and Applied Social Psychology, 7, 257-267.
- Gilbert, P. (1998). The evolved basis and adaptive functions of cognitive distortions. British Journal of Medical Psychology, 71, 447-463.
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