I have a theory. It isn’t evidence based, just formulated from psychology courses, observations and experience. If you work in care, you might ask yourself whether you are a controller or a victim. What was the motivation for getting a job in care? Did you want to help people or were you in it for monetary reasons?

Care attracts two types of people – the controllers and the victims. The victims are those who feel angry about injustice because they have suffered injustice. They generally want to empower and advocate for those who are vulnerable and will speak up for their rights.

Empowering others is about enabling people to achieve what they want to achieve. This is where choice comes in. The role of the carer is the tool of the client or patient so as they can achieve their goals. The attitude here is instead of ‘you can’t do that’; it is ‘how can we enable you to achieve your goal?’ This is called a client-centred approach. It enables the person to make an informed choice.

If you are a carer that has this in as a priority in your practice, then you are probably a victim. You are a victim because systems are put in place, by the controllers, so as care can be managed at the convenience of the establishment. If you are truly client-centred, you would be an anarchist, or advocate, fighting the system to benefit your client or patient. You would be in a no-win situation because the system is designed in a manner that ‘mother knows best’. This isn’t about choice, but management convenience. If you protest for the rights of your patient, those in power will consider you problematic and a chance of promotion will not be offered. At best, the carer (victim) remains in that position, scapegoated and powerless. At worst, he/she is psychologically forced out by other’s closing rank, until they leave. Both situations, ultimately, doesn’t help the client or patient. The situation the carer, as victim, find themselves in is a reoccurrent one. They have lived with this status most of their lives, so the cyclic behaviour starts again. They have suffered injustice, so the fight for the rights and injustice of others.

So, are you a victim carer or a controller carer?

As a controlling carer, you might be attracted to care because you want to 'help' people.  Click ‘help’ for definition. ‘Helping’ blurs the boundary between empowerment and enabling. Yourdictionary.com defines help as to make things easier or better, to do for (either partly or wholly) and to assist. Helping isn’t empowering and enabling. Empowerment talks about the client or patient having the resources and tools to make an informed choice. To enable a patient or client is to make available, provide with the means the opportunity to fulfil that choice. An example of empowering tools is that of a living will.  Click living will for more information.

The controlling carer, therefore, will soon find himself in a position of power because he adheres to the practices and procedures of the authoritative guides and legislation. A client is told; therefore, he can’t fulfil his wishes because it goes against his care plan. The mere fact that care has a plan, therefore, is controlling in itself, whether the client is in at the meeting where this plan is taken in effect or not.

The controlling carer keeps in mind budgets and cost containment. He may get a bonus for keeping costs down and kudos points from higher management. It, therefore, goes that anyone that is a threat to these practices and procedures must be kept in place. After all, rules are in place to keep us from harm. He/she is, ultimately helping the client – ‘mother knows best’.

To help, therefore, has its benefits in the system.  The perspective of the controller is doing his/her best to provide care.  They kid themselves they are practicing a client centred approach within the bounds of an informed choice.  This is only an informed choice, however, because the client is informed of the changes.  The victim carers would argue that this would be a restricted choice.

In view that people group themselves with like-minded people, it would be no surprise, therefore, if the victims grouped together whilst the controllers help each other climb up the management ranks to greater status with more money. 

In psychology terms, it is known that societies victims tend to remain victims. It has been written that in the grand scheme of things, this is the order of life. Victims are happy to be fulfil this role as they know no other way, whereas the controllers like to feel powerful and in control.

Often power is associated with money and status. This is a great motivation. Although a controlling carer may start off with the intention of ‘helping’, or what they perceive as this, the nature of their psychology soon comes into play in their behaviour. The nature of behaviour is the same with all humans; only the victim careers motivation is that of standing up for injustice.

So here you have it. If you work in care and are honest with yourself, which one are you? The controller or the victim?

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