When I was in the substance misuse field of work, I often found people struggling with needing to put dilemmas to bed with an answer. Right now. ‘Should I do this or that? There are pros and cons to each but I must figure it out, think it through, decide… or it will be a source of constant stress.’ I noticed people exhaustingly busy with thoughts and physical manifestations of this stress.
Some of my friends now, outside of substance issues, have intensely logical minds and want answers, diagnoses, solutions. They need to figure out problems and solve them.
I’m a person who finds it quite easy to say that I don’t know, that I am taking time to absorb all of the facts, that I am setting things aside to deal with when the whole picture becomes clear later on. Of course, I make decisions all of the time but I am equally at home with not deciding, taking a more reflective approach at times as well.
Is this a personality trait or a learned skill? I know that there were several tools and methods that were helpful in the substance misuse field to clarify choices. ACT therapy (Acceptance Commitment Therapy) where the person accepts that he/she only really has control of his/her own behaviour and that behaviour is a clear choice if we choose to notice it. Also motivational interviewing helped with looking at the motivation behind choices. There were many more skills that could be learned to support anxieties and behaviour patterns. I am sure that I absorbed some of these skills in the field of work.
How does all of this relate to dementia? Wel, I think it might –
One lady that I have been working with for a long time and who has been very active in this project has a similar outlook to my own. She is happy to say that she doesn’t know – happy to accept the mysteries of this advancing disease with a wave of her hand and an ‘I don’t know, darling, I have no memory’. Although she absolutely feels all of the losses and struggles in her life, the mysteries of her memory loss aren’t the biggest deal to her. A very intelligent lady, a Mother and housewife for most of her life, and a crofter, she enjoys puzzles, reading, socialising, enormously long words and maintains a full life into her nineties, there is definitely something in her approach to not knowing that supports her to manage her life and happiness. I hope that I would be able to adopt similar strategies under similar circumstances.
Another lady that I have been working with is quite opposite in her outlook. She is a very logical lady, held down a responsible job in her working life and her mind is constantly busy with figuring out reasons for everything around her. It was a stressful time moving from hospital to a care home, as she had decided that the room must be her bedroom and that the man coming to say goodbye was the Council man coming to evict her. Her first few days at the care centre were very difficult for her. I took her to a weaving workshop and although a lot of reassurance was required during the journey, the left and right, rhythmic hand movements enabled her to sit with former school friends and weave willow, gently, skilfully, socialising and this eased her busy mind and kept her in the moment.
Two women, two personalities, two completely different lives led, along with completely different skill sets.
Is their separate response to dementia, to not knowing, a personality trait or a set of learned skills? Something for future research and discussion, perhaps? This is another train of thought about which I am comfortably sitting with, without knowing, adding more evidence to the train of thought as it arises in my work.