The Five Relational Spheres – an offer for mental health awareness week, and beyond.

by David Gilbert

May 13, 2024

A framework is a temporary offer. If it makes sense, then it is all to the good.

During the last eighteen months, nothing has made much sense. But every now and again, I am caught with my mind grazing over a way of seeing the world that sort of aligns with what my body, mind and dare I say it, spirit, feel is a way of connecting to the different aspects of my life.

I offer it to you particularly if you are struggling.

The Five Relational Spheres

Our life is made up of a series of nested relationships – you can imagine these perhaps as a series of concentric circles, or like a Russian doll.

1. With Our Selves

Our primary relationship, not often viewed as such, is with and within ourselves. I’ve often argued in my political work around mental health and life-changing illness, that when we are unwell, our relationship to ourselves is broken. Our thoughts are at war with our body. Our mind is sparring itself. Our cognitions, perceptions and sensations (feelings, emotions) are misaligned. Our judgements, fears, interpretations, assumptions, are battling with our rationality or objectivity. We are deeply out of balance within this sphere we call our ‘self’. Our very identity – locked as it is on what we think, idealise or believe – is at risk, from this ongoing seething battle. We are, put simply, broken. This is why, I’ve argued, that we make such good leaders potentially. They/we know what healing relationships look like and recognise their primacy in our own rebuilding.

The work, and it is hard deep work, if we are taking it seriously (as we should) is to find ways to ‘be’ with ourselves, to integrate, to come back into balance, to make peace. This article is not a plea for one method or therapy by which to do this, but merely to note that this is one aspect of relational care, or self-care.

2. With Others

The second relationship we have is with others. When unwell, particularly with mental health conditions, our relationships with those close to us, and less close to us, become strained often. How we connect with others frames our psychological safety – we are social beings, and when isolated become locked off from connections that should provide solace and comfort. The impact of Covid revealed this effect powerfully. More personally, I found out the hard way that there are very few visitors on a psychiatric ward. The last eighteen months of my recent hellish period have shown who my friends are and who they are not. My rebuild has now to include me getting ‘out there’, to be with friends and also learn how again to be in a social environment. And how should I know re-focus on my family and domestic relationships. My loved ones: They come first, and should always.

3. With Society

The third relationship we have is with ‘society’. I know I am not being academic in formal terms, but I think there is something fundamental about how we are – or perhaps who we are – in societal terms. This is the ‘meaning’ we give to our lives, perhaps also through relationships, but through our role, our work (we often lose ourselves over-identifying in this realm), our purpose, our vision, our mission – this is something I am struggling with as I lose my (admittedly slightly neurotic) ambition around my work on patient leadership. At 62, ‘what’s the point?’ Is the question I struggle with, as I note the lack of changes I and we have made. But more widely, should I be doing more as a Jew? Should I be doing more to tackle any one of a dozen causes I care about?

4. With Our Environment (place)

The fourth relationship we have is with our environment, our place, our physical (or perhaps virtual) space – this includes now for us the threat from climate change; what is our relationship with the planet, from the microcosm of local green action through to whether we should be actively protesting on the streets. But it also includes the fact that I picked up litter this morning (or didn’t?) and how I care for my home – is it a balanced environment in which to live?

In my work on mental health and safety, I have noticed that those who advocate for ‘safe environments’ can mean one or other of two aspects – a contained space where in-patients are judged ‘not at risk to themselves or others’ (isolation, incarceration, restraint) or ‘psychological safety’ (relationships to others around you, avoiding re-traumatisation of isolation or restraint). Here we see that the relational spheres are not mutually independent.

5. With The Divine

The fifth relationship we have is the ‘divine’ – with god, with spirit, with something beyond us. Not everyone will acknowledge this domain, for whatever reason. Fair enough. I am the most doubtful person I know. But so many of us call ourselves ‘spiritual’ or seek deeper meaning.

And I can’t help believing or perhaps wanting to believe (what is it in us that ‘reaches’?) that there is something beyond my will to stay alive. I have not always wanted to – I have been significantly unwell for nine years in total, 24/7, out of my 62 year life. What has kept me going? My ‘will to life’? Where does that come from? More prosaically, it seems arrogant to me that I – little me – is self-centred enough to believe that I am what life is made for. So, on a merely personal level, my desired relationship with the divine is a search for something beyond myself, beyond our seemingly wilful little species. Maybe it is also the Jew in me? Or the mere fact I like the buddhist approaches. Who knows – do you?

These five relationships are constantly in our minds, our bodies, our souls, if you like. Each is difficult in itself to navigate. But I have come to think they might be a handy form of reference for those trying to think through moments of crisis at any one or more of these levels. What parts are you made of yourself, how do you relate to different aspects of yourself? How do you relate to others? What do you want to do or be in life? What’s happening around you (in your home, on your street, on earth)? Does life hold meaning?

Each of the above relational spheres – if you believe the above to be useful – require us to bring two aspects of our selves to bear – our ‘attention’ and our ‘intention’.

The former, is how we observe what is happening – to our selves, with others, in relation to society (and our role in it), our ‘place or space’ and the divine

Attention: This itself is a matter of being mindful – because it is easy to fall into misjudgements based on our interpretations of what is happening; we label something (ourselves, others, society/systems, our physical environment, god or whatever) as good/bad; judge it as aligning or not to our biases or known familiar habitual responses. In each of the five relationships, how do we listen and notice and adjust what we think or do? In other words, how are we to be ‘conscious’, ‘aware’ ‘alive’?

Intention: This is about what we wish to do, how we wish to be, to behave… do we act unkindly or not? How do we balance independence and belonging? Freedoms and safety? Can we stop ourselves acting or behaving out of familiar habit. How do we break free? This is partly to do with the act of will, and how slowly we restore agency to what we can do (this is something I am finding particularly hard to do in relation to judgements about myself, others, the ‘system’). This is where our ideologies or religion hold so much unconscious sway.

If we can find a way of recognising how we can bring our attention to what is happening in more balanced ways – free from the gusts of emotion – and then find agency or control over our responses, I would argue therein lies freedom.

I hope the above is a useful framework. If not, then dispose of it, don’t think about it again. If it helps to make sense of things, even a little, then it will have served its temporary purpose.

And I wish you courage, insight and kindness and freedom fear – all those things I wish I had more of.

All blog posts
what we do

Leave a Reply

Your email address will not be published. Required fields are marked *

patient leadership newsletter

Sign up to our Patient Leadership Newsletter and get a free eBook

When you sign up to the quarterly Patient Leadership Newsletter you will receive a free download of The Rise of Patient Leadership, an eBook collection of David Gilbert's most popular articles.

Get a free eBook of David Gilbert's most popular articles

Subscription Form (#8)