Please read the following scenario and then discuss the questions.
Ian and Kyle have built a really good relationship and have a lot in common. Kyle has been talking to Ian about feeling tired all the time and thinks it’s his medication. Ian is sympathetic because he takes the same medication. Today Kyle comes in and is very animated and asks if he can talk to Ian in private
Kyle: ‘I’m finally feeling a little more energetic and it’s a wonderful feeling. I’ve been slowly cutting back on my medication and it’s working really well, but I don’t want you to tell anyone because I’m afraid if the doctor or case manager finds out, they’ll make me go to the hospital.’
- What is your immediate reaction to this scenario?
- What are the ethical issues raised by the scenario?
- How can you respond in a way that is honest and respectful and still maintain a mutually empowering peer relationship?
- Think about the drama triangle we learned about in Session 5. What might happen to the relationship if you take a persecuting position (‘you have to take your medications’) or a rescuing position (‘OK, sure, I’ll be there whenever you need me’) or a victim position (‘I can’t believe you are asking me to do this. I could lose my job/position’
The ethical issues here are complex. On the one hand it’s never a good idea to keep secrets, but on the other hand, you don’t want to abuse your power by overreacting. What is clear it that at this point we do not have all the information needed.
Think about the type of questions they could ask Kyle. This could
- Why does Kyle believe he will be hospitalised if his doctor or case manager knows?
- Is there a way he could talk to his doctor and get his help to decrease his medication?
- What kind of support will he need to do this?
There is a need to remind Kyle of the mutuality of the peer relationship and the respect for each other that underpins this. Being asked to keep a secret isn’t very respectful. Ian should be honest about his feelings about his and tell Kyle that he is uncomfortable with what he is being asked to do. This can include discussing that he does not want to feel responsible if something goes wrong. One approach would be to suggest that they both share this with someone else to get more information.
However, it is important to have empathy for Kyle’s situation and try to see things from his perspective. This will include acknowledging his view that he feels as if he has much more energy and is enjoying it. If this is done then it is less likely that the peer supporter will fall into the negative traps of taking power positions (persecuting, rescuing and victim) as all of these positions are more to do with our own fears and outcomes than they are about Kyle’s position.
In this scenario there is no one right way to respond. However to negotiate something that will work for both of you, you need to have made a connection and be maintaining a peer relationship that is empathetic, mutual and empowering.