Psychosocial what?

  • Rob Sloan

This is the second blog in my series of ‘Y Tho’…why we do what we do.

I’ll be talking about:

– Designing for health…(it’s not a case of them and us)

– The mighty Erik Erikson, inventor of the identity crisis

– Where the diagnosis of MS sits in the context of life

One of our learnings when designing for health has been to avoid an ‘us and them’ mentality. We’re all people and as soon as that’s forgotten, we end up designing things that are a bit…well, alien.

For example, if we were to design for people experiencing balance issues, the first stage of research might be to speak to people who navigate balance on a daily basis and understand their coping strategies…people standing on public transport, gymnasts, surfers, tightrope walkers…going outside of health as a starting point and putting people at the centre builds a strong foundation.

One of the phrases that comes up again and again on our forum is that a health condition doesn’t define you…so the first stage of designing for health is to forget that you are, and unpick what really matters on a human level.

This brings me back to my current project: before looking at the needs of someone diagnosed with MS, I want to understand where diagnosis fits in the context of human development, the development of anyone reading this blog…and that’s where Erik Erikson comes in.

I was looking for a reference to kick me off – I wanted know if there was any theory out there about human development over a lifetime. I didn’t want to fall into the trap of creating a one dimensional version of life…goes to school, goes to university, gets a job, buys a house…this wouldn’t tell me a lot and wouldn’t be truly representative.

The model I stuck with (Erikson’s stages of psychosocial development), addresses life in broad terms…he talks about eight stages:

Trust vs. Mistrust.
Autonomy vs. Shame and Doubt.
Initiative vs. Guilt.
Industry (competence) vs. Inferiority.
Identity vs. Role Confusion.
Intimacy vs. Isolation.
Generativity vs. Stagnation.
Ego Integrity vs. Despair.

At each stage there’s an either or…for example, without gaining a sense of identity, you end up with role confusion or an identity crisis. Something to note is that there’s a distinct time in Erikson’s model that during a person’s development, they go from focussing on themselves and their pressing needs, to seeing those around them, trying to establish where they fit in the grand scheme of things and start looking to the future.

I’ve had a go at a timeline below:

The next phase is to map what we know about MS against this timeline, I’ve done a load of concepts (below) and the one clear communication isn’t quite there yet, but I’ve learnt a few bits and pieces:

Learning one:

Everyone develops at different rates and has different needs across their lives, this communication tool needs to show that…I’m almost seeing it as an timeline in after effects with moving parts…

Learning two:

People start to think about others and look outside themselves at a very early early age (as early as ten according to Erikson).

Learning three:

In terms of MS, the diagnosis of Relapsing Remitting averages at 30 years old – but it could be as early as twenty.

If we go back to Erikson’s model, this is just after the stage of ‘identity vs. role confusion’ – people will have spent their late teens working out exactly who they are and what their plans are for the future, only for a condition to be thrown in.

Between 18 and 40 there’s a phase that Erikson has called ‘intimacy vs. isolation’, people are looking to forge relationships and if they don’t, they could be faced with a sense of isolation. Again, a diagnosis could have the potential to tilt the scale here.

Maintaining identity and reducing isolation are two elements that Shift.ms focus on – we talk about identity and about not giving up on your ambitions, just working out how to achieve them. We also talk about reducing isolation around diagnosis through talking to people who understand – one of the main reasons we were founded. What we’ve never taken on board is when in a person’s natural development, issues like identity and intimacy are most prominent, and that one paves the way for the other…

The next phase of my project is to start mapping out MSer needs. I’m interested in needs starting at a diagnosis (how do people react?), all the way through to later life.

– What’s the thinking generally about MSer needs?
– What’s on our forum that I can use?
– What research have we done in the past that I can pull together?

Right, onwards!

If you haven’t seen my previous blog which gives the project a bit of context, check it out here.

The next blog in the series, I need [x] so that [y] can be read here…

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