Care to Care: Righting reflex
Watch the corresponding Care to Care episode here.
In graduate school, one of the first therapeutic approaches we learned was motivational interviewing. This is a style of engaging with patients in which a therapist uses open-ended questions, affirmation, reflection, and summarization to help facilitate change. Motivational interviewing is commonly used across many disciplines and can be very helpful, particularly when someone is ambivalent about a choice or decision.
Within motivational interviewing is the concept of the “righting reflex.” The righting reflex is the urge to fix or problem solve for someone that is struggling. This urge often comes from a well-intended place. It is difficult to see the people we care about struggle. If we think we have a solution, doesn’t it make sense to tell them what to do? While there are absolutely times that problem-solving is appropriate, sometimes trying to fix a problem for someone else can actually be ineffective or counterproductive.
When caring for a loved one– whether it be in the context of a cancer diagnosis as in my case or in the context of another health issue–our first instinct is often to fight. It makes sense to want to devote every ounce of our energy towards finding solutions, exploring treatment options, and doing whatever we can to "fix" the situation. However, while the righting reflex serves an important evolutionary purpose by compelling us to take action in the face of threats, there are times when it may actually work against caregivers. For example, cancer and many chronic health conditions are simply problems that cannot be solved. Chronic illness is often a physical and emotional process that cannot always be contained, figured out, or understood through sheer willpower and problem-solving alone.
When caregivers and care-recipients are not on the same page in a conversation, friction can arise. One of the most important things in communication is that both participants are aligned on what is needed in the conversation. Conversation can serve many different functions. Sometimes when we talk to people we just want to be supported, sometimes we want to be validated, and sometimes we want help problem- solving.
In an article in the New York Times, journalist Jancee Dunn reported a simple way to ask someone what they need in a time of emotional overwhelm: “Do you want to be helped, heard, or hugged?” Everyone handles stressful situations differently and none of us, neither caregivers or care recipients, are mind readers. So why not ask each other what we need in a conversation? Do we want to be helped (problem-solving), heard (validation), or hugged (support)? This question can be extremely powerful because it clarifies needs, de-escalates emotions, and helps create space for effective action.
In my experience as a care recipient learning to ask what I need for in a conversation has positively shaped interactions with my caregivers. My mother, by nature, is a problem solver. While this is often extremely helpful, there have been moments in my journey where I needed to be heard or hugged, not helped. For me, gently prefacing conversations with something like “this is not a problem-solving conversation” or “I’m not looking for solutions right now” helped signal to my mom when I just needed her support or validation.
From the caregiver perspective, asking up-front what the care recipient needs in a conversation can be a useful approach. Something as simple as “how can I help?” leaves more space to meet the care-recipient’s needs without making assumptions. Often, simply being with the care-recipient will be enough.
It's totally understandable to want to fix the problems faced by someone you love. Just remember, the most meaningful care we can provide often comes through simple presence and compassion. By noticing our compulsion to constantly correct, adjust, and re-center, we create space to fully empathize and connect with one another.