Wednesday, 18 August 2021

Safety, Responsibility, and Trust: Thoughts Inspired by a Drive with a Friend

I took a drive with a friend the other day. It was the first time I’d been in a private car in over a year and the first time my friend had driven me anywhere. She has yet to pass her driving test and I was there to supervise so she could gain additional practice. We had a great time and I felt completely at ease in the car with her. Thinking about it afterwards, it occurred to me how important safety, trust, and responsibility are in our lives.

Trust and Physical Safety

I was supervising but I was very much in my friend’s hands. I trusted her driving ability and sense of responsibility. If she felt confident behind the wheel, that was good enough for me. No matter how experienced we may be, every driver understands what’s at stake when we start the engine and pull out into traffic. We are responsible not only for our own safety but that of our passengers, other road users, and pedestrians. Many of us drive so frequently we take this for granted but it’s worth reminding ourselves every now and then.

We stopped for lunch, which raised further questions of safety and trust; this time from a covid perspective. Back in March as England began to emerge from lockdown I shared my fears that things would never be the same as in pre-covid days. A few months later, I was struggling mentally, in part because it seemed I had little or nothing to look forward to. I’ve taken a number of steps forward since then. I’ve met with friends a few times, including an urban ramble around Newcastle. I’ve revisited some of my favourite places and spent a day in Edinburgh.

Nevertheless, as we entered the restaurant I felt on edge. Was it covid-safe? Were the tables far enough apart? Were customers and staff wearing masks? Now that rules have been eased, safety is much more a question of responsibility and trust. My friend and I are fully vaccinated. We felt safe in the car without masks but kept the windows open. We wore our masks inside the pub until we found a table, and when ordering at the bar. The place was fairly busy but the tables weren’t too close together and we felt safe. Had we not, we would have gone elsewhere.

Later that day I called into one of my favourite bars. I expected it to be busy but it was literally heaving with people. I used to love the atmosphere but on this occasion, I was uneasy. It may not have been unsafe, but it felt so. I trusted my instinct and came away.

Safety and Challenge

There’s a flip side to all this talk of safety. Many of us deliberately put ourselves in situations where we are — or feel — unsafe or in danger. Whether it’s scary movies, roller coasters, extreme sports, or pursuits like mountaineering or skydiving, we challenge ourselves for kicks or personal growth.

Fran told me recently of a time she was on a wilderness trail and felt unsafe navigating the rocky terrain. It reminded me of the time in the early 1980s when a university friend and I ascended Snowdon, Wales’ highest mountain. Our route included Crib Goch which I’ve since learned is “an adrenaline-fuelled gut-wrenching scary arĂȘte [...] not to be undertaken lightly.” My friend was a seasoned hiker and I’d trusted him to choose our route, but I was out of my depth as we picked our way along the ridge, with mist filling the valley on one side and on the other, a clear drop to the rocks below. I’ve never felt as unsafe as I did that day.

A few years ago I did two zip wire slides for charity from Newcastle’s Tyne Bridge. Friends praised my bravery, but in truth, I felt perfectly safe. I trusted the event organisers to know what they were doing and I trusted the safety equipment and procedures. It was scary, but it was safe-scary. Challenges help us expand our horizons, as long as we choose them wisely.

Feeling Safe to Be Ourselves

Another important safety is feeling we can be open and honest without being judged or rejected. This requires trust, in other people and in ourselves, but also the responsibility not to share indiscriminately. As BrenĂ© Brown puts it in her book Daring Greatly, “Oversharing is not vulnerability. In fact, it often results in disconnection, distrust, and disengagement.” You can read more about vulnerability vs. oversharing in this excellent article by Hannah Braime.

Our ability to share appropriately can be compromised by illness. Fran experienced this during a period of mania, as we describe in our book High Tide, Low Tide:

In the grip of mania, Fran clamoured for attention, and pushed her ideas at people whether they wanted to listen or not. She was capable of presenting herself with stunning clarity, but at other times her thoughts could be hard to follow. Such behaviour disturbs, worries, and alienates people. Some approached Fran with kindness, but from others there was mistrust and misunderstanding.

I’m fortunate to have friends with whom I feel completely safe, and trust implicitly. I wrote about some of these recently in a post I titled Team Marty because that’s how it feels to have them on my side.

Safety and Trust in Professionals

We have a responsibility to look after ourselves, but our health also depends on our doctors and other professionals. Trust is essential. If we trust the people involved in our care we’re more likely to follow their guidance. That doesn’t mean we should accept things naively or uncritically. As in any profession, mistakes can and do happen and need to be challenged.

When we met in 2011, Fran’s mania was poorly controlled by her prescribed medication. No one was necessarily to blame. Symptoms of bipolar disorder are prone to change over time, requiring adjustments in treatment. Despite all she’s been through, Fran has never lost trust in her clinicians. This is nowhere better expressed than in the open letter she wrote to her psychiatrist when he retired.

Not everyone’s had a positive experience with the medical profession, of course. Chris Good shared his experience with us in a guest post titled Twenty-Plus Years of Misdiagnosis and Incorrect Treatment. Another friend suffered due to a serious dispensing error, as I’ve described previously:

[The] pharmacy stopped dispensing one medication altogether. This wasn’t spotted for some weeks, during which my friend’s stability and safety were severely compromised. It was an error with potentially serious repercussions. Even after the mistake was corrected it took time to restore the full protective benefits of the medication. It’s fair to say my friend will pay very close attention from now on to what is dispensed.

You can read my friend’s account of the incident here.

Safety, Suicide, and Self-Harm

The final aspect of safety, trust, and responsibility I want to discuss is safety from self-harm and suicide. It’s a subject close to my heart. Fran and I devote an entire chapter of our book to it (“The ‘S’ Word: Being There When Your Friend Is Suicidal”). Suicidal ideation is less present for Fran than it used to be, but we remain vigilant. Suicidality and the urge to self-harm are an ongoing or recurrent reality for many, including several of my friends. Information, support lines, and training courses are widely available. I’ve previously pulled together a list of suicide awareness and prevention courses, and you can find further information on our resources page.

Strategies for staying safe are necessarily personal but may include a Wellness Recovery Action Plan (WRAP), Dialectical Behavioural Therapy (DBT), or other techniques. Fran has a personal care manual and travel wellness plan. My friend and fellow mental health blogger Aimee Wilson has written extensively on her use of DBT, including this detailed guide.

What matters most is that the strategies work for the person concerned. For many years, Fran kept a stash of medication. Others might disapprove, but she considered it protective because it filled a need that might otherwise have found expression in more dangerous ways. In her words, “I needed the insurance to escape. Perhaps because this was the only thing in my life I had control over and I needed to do it my way, not everyone else’s way.” As I trusted she would, Fran voluntarily relinquished her stash when the time felt right.

Trust distinguishes caring about someone from worrying about them. These terms are often used interchangeably but there are important differences between them:

When we care about a friend we are expressing our trust in their abilities, strengths, and resilience. We trust ourselves to support them as best we can, and others to contribute as they are able. We don’t feel we have to do it on our own, fix everything, or find all the answers.

When we worry about a friend we express fear that they lack the resources to meet whatever challenges they are facing. We fear we don’t know what we are doing, that we will be found lacking, or not up to the task. We fear others won’t be around to contribute, and we will be left doing everything ourselves.

There Are No Guarantees

It’s worth reminding ourselves that trust and responsibility are no guarantee of safety. All we can do is our best, and all we can expect of others is that they do their best. For me, the clearest example of this is my relationship with Fran. She trusts me to be there for her, to be on her side, to fight her corner, and to always have her best interests at heart. For my part, I trust that I will handle whatever might come up. That doesn’t mean I can or have to handle everything on my own. I’m one member of a team of people — professionals and other friends — Fran trusts to help her stay as safe and as well as possible. I nevertheless accept that no one and nothing can guarantee Fran’s safety. This is nowhere better expressed than in this excerpt from our book:

Fran has told me many times I help keep her alive. There is no objective way to know if that is true, but I take her words at face value. I cannot explain my lack of fear when she is suicidal, but trust is fundamental. [...] It is not that I trust Fran never to try to harm herself, or imagine our friendship guarantees her safety. She has never attempted suicide, but she knows what to do, and I take very seriously any hint she is thinking about hurting herself or ending her life. But I trust her to not hide her suicidal feelings from me, and to be honest with me about them. Ultimately, I trust Fran to allow me to help her stay alive.

Responsibility and Self-care

We all need a hand to hold and people to trust, but it’s important not to rely on the same people all the time. Fran is happy I have others in my life I can turn to because meeting all my needs would be too much. There are times when she needs all her focus and energy to take care of herself, or is simply unable to help me deal with what’s going on for me. She trusts me to do whatever I need to keep myself safe.

Afterword

This discussion might appear to have come a long way from its inspiration in the passenger seat of my friend’s car, but I believe it shows how important safety, trust, and responsibility are. How do these themes play out in your life? Do you have any safety strategies you would like to share? Who do you trust most, and why? We’d love to hear from you.

 

Photo by takahiro taguchi on Unsplash.

 

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