Interpersonal Connection: Noticing the Needs of Others

Interpersonal Connection: Noticing the Needs of Others

by David H. Rosmarin
The key to helping clients build richer and fuller lives is interpersonal connection.

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Ancient Roots

In my recent book, I introduced an approach to physical, emotional, and spiritual health called The Connections Paradigm. This is a technique derived from an ancient Jewish tradition that I have used successfully in my clinical practice with clients.

The idea behind the paradigm is that human beings, at any given moment, are either “connected” or “disconnected” across three key relationships. To be “connected” means to be in a loving, harmonious, and fulfilling relationship; to be “disconnected” means, of course, the opposite.

The three relationships are those between our souls and our bodies (Inner Connection), ourselves and others (Interpersonal Connection,) and ourselves and a Higher Power (Spiritual Connection). These relationships are hierarchical, with each depending on the one that precedes it.

I began learning about interpersonal connection early in my career as a clinician. Back then, I was meeting with patients who seemed to have every need you could imagine. Some of my patients had needs that were similar to my own; others had needs that I never personally experienced.

I struggled to place myself in the shoes of people who lived in circumstances very different from my own
I struggled to place myself in the shoes of people who lived in circumstances very different from my own, like the time I worked on a geriatric unit and treated several older patients with age-related problems that I had never encountered. There were other patients from whom I learned about culture-specific needs that I will probably never fully grasp, let alone experience. In other cases, I saw needs associated with specific health concerns that I never had, and with dire personal and financial circumstances that I pray to avoid during my lifetime.

Through this process, I concluded that being sensitive to each patient’s needs—i.e., interpersonal connection—is one of the most important skills in being an effective therapist.

I have also observed the most common ways that people fail to notice the needs of others. Once, a twenty-nine-year-old male patient of mine named Danny completely disputed the importance of noticing other people’s needs.

“I’m more of a doer,” Danny told me. “I only feel like I’m making progress when I’m actively involved in something. And at the end of the day, getting things done is more important than thinking about other people.”

“But how do you know what another person needs unless you develop your sensitivity?” I asked.

“A lot of the time their needs are obvious,” he said. “And if not, they should tell me.”

“Doesn’t it feel better when someone notices your needs without you telling them?”

“Um . . . ​I guess so,” he said.

“And let’s be honest,” I said, “do people really always know what they need? There are times when everyone in someone’s life can see clearly what they need except them. And sometimes we are sure we need one thing, but someone else can see that we really need something else.”

“What’s your point?” Danny asked. “I just don’t want to sit and think about other people, I guess. Is that so bad?”


Danny’s Story

Danny first came to treatment after a brief psychiatric hospital inpatient stay for severe depression. He had lived at his parents’ home for several years after college until he finally got a job and decided to move out. Within a few months, however, he was seriously considering suicide and ultimately checked himself into a hospital.

I’ve always gotten depressed, but this was worse
I’ve always gotten depressed, but this was worse,” he said. “When I was living by myself, I was not really thriving. I had a job I hated and not much of a social life. I thought about moving home, but my depression just kept getting worse until I knew I needed to go into the hospital. I had to stop working, and I didn’t really have enough money.”

After his hospital stay, Danny decided to move back home with his parents. “I just need some time to relax and not worry about bills,” he said.

Danny’s psychiatrists recommended outpatient care, and he came to my New York clinic a few days after he left the hospital. As part of his treatment, I stressed the importance of self-care, positive thinking, and staying active. His condition improved relatively quickly. But as he started getting better, he experienced a backlash from his siblings.

Danny’s parents were elderly and had health problems. His father, 84 years old, was going through the early stages of dementia, and his 75-year-old mother, who had suffered several bone fractures as a result of severe osteoporosis, could no longer go up and down the stairs without help. They both struggled to do basic chores to keep their house in order, and Danny’s siblings felt that he was putting pressure on them by moving back home.

“I basically do whatever my parents ask me to do,” Danny said. “We have a good relationship. They say they’re happy that I’m home. But my brothers and sisters say I’m making it harder for them. Last weekend we all had a ‘siblings meeting’ to talk about Mom and Dad, and they basically ganged up on me. They said the house is dirty and that I’m not keeping up with the laundry and stuff like that. My older brother comes just about every day and he’s been giving me the stink eye for months, and I really didn’t know why until this weekend. We used to be really close. But now that I know how they feel I’m really annoyed.”

Danny was spending a lot of time applying for jobs and making sure he was taking care of himself so that his depression would not return. “They think I’m just sitting around doing nothing,” he said, “but I need to focus on getting back on my feet. And really, the house is not that messy. My parents have complex medical issues, but basically they’re doing okay.”

“You said you do everything your parents ask you to do,” I said. “So what are those things?”

“They don’t even ask me to do much. Sometimes my mom will ask me to help her get up the stairs, or my dad will ask me to help him to move something heavy. But they like to handle things on their own.”

With Danny’s permission, I spoke with his parents and siblings and got an entirely different story.
Danny was simply not aware that he was creating a significant financial and interpersonal burden on his parents and making their old age much more stressful
Danny was simply not aware that he was creating a significant financial and interpersonal burden on his parents and making their old age much more stressful. He expected that his mother would cook, clean, and do laundry for him, and he would routinely leave his belongings around the house, even though they presented a tripping hazard for his parents.

His siblings were frustrated and even exasperated with his selfishness, to the point that they wanted to throw him out of their parents’ home even if it would lead to rehospitalization or worse. I managed to calm the siblings down, with the hope that I could get through to Danny in therapy.

During the next few sessions, I continued to discuss the core concepts of interpersonal connection with Danny, and he eventually acknowledged that his interpersonal style was a significant contributor to his depression over time.


Other Peoples’ Needs

“Years ago, when I lived in California with a friend after college, it was my highest point of functioning. I had a job, a girlfriend, and things were going pretty well. But over time, my friends got fed up with me because I have this unhealthy tendency to focus on myself more than others. I grew apart from my girlfriend and also my roommate, and eventually moved out on my own. But the costs of living were so expensive, and the next thing I knew, I was in major debt. It’s been a bad situation ever since.”

“There are ways to improve how you connect with others,” I told Danny, and he seemed interested to learn more. “Interpersonal connection starts with noticing other people and what they need, and eventually making an effort to make them happy. Being sensitive to others’ needs helps us to remain connected to others and helps us to feel more confident and happier ourselves.”
being sensitive to others’ needs helps us to remain connected to others and helps us to feel more confident and happier ourselves


As a preliminary exercise, I encouraged Danny to make a comprehensive list of someone else’s needs. Danny initially wanted to focus on his older brother, but I encouraged him to choose one of his parents instead. “You see them a lot more often,” I said, “so you have a better perspective on what they need. And they seem to have a lot of difficulties right now, so many of their needs are more noticeable.”

Danny reacted negatively to my suggestion, suspecting it indicated my agreement with his siblings that he was not caring for his parents’ needs. “I’m not making any judgments on how you’re behaving in your relationships,” I said. “You’re my patient. I’m focused on helping you.” Danny reluctantly complied with my recommendation, and we spent nearly half a session making a list of all his parents’ needs.

The exercise turned out to be a powerful experience for him. He became especially conscious of the consequences of his parents’ physical health decline, and how he had indeed become more of a burden to them than he had previously acknowledged.

At our next session he said, “It’s hard for both of them to go out anymore. My dad used to be so active, he took a lot of pride in his work. Now he can’t do anything but sit at home and watch TV. It’s definitely not easy for my mom that she can’t go out to see my nieces and nephews. She used to take care of them every day, but now it’s too hard for her even to go visit them at all.”

It was slow going, but we were getting somewhere.
it was slow going, but we were getting somewhere


In truth, Danny had already been aware of his parents’ needs, but verbalizing them made them more visceral. I asked him to focus not only on his parents’ emotional needs but also on their physical needs. “Well, when it comes to physical needs, I guess they have enough money, so they’ve got that taken care of.”

“But your mom is in a lot of pain, right? Relief from pain is also a very strong physical need,” I said.

“That’s true. But I can’t do anything about that.”

“Maybe, but the point is to consider her needs, not necessarily to solve them. What about your dad?”

“He moves okay and he’s not in pain, but I guess his dementia makes it hard for him to handle all the basic things that he used to do to feel good. We put notes around the house because he doesn’t always remember where things are or how to use them. My brother told me we’re all going to start wearing name tags when his dementia worsens.”

Danny became emotional as he began taking serious stock of all the ways his parents were struggling to meet their own needs. “The thing is,” he said, “I still can’t see how it helps for me to get upset about it. It’s not like there’s anything I can do.”

“Maybe not,” I replied, “but being mindful of other people’s problems is important. That feeling of empathy you’re experiencing now is interpersonal connection. I can see now why it’s hard for you. The truth is that you really feel their pain. It’s very hard for you to see them suffer. It’s actually because you are a caring person inside that it’s so challenging for you to acknowledge that they are suffering.”

Danny started to cry, and then a wellspring of emotion came forth. He was visibly distraught with how his parents were suffering and how he had contributed to their pain. Over the following month, Danny’s behavior started to change. He not only improved his self-care but became much more considerate of his parents’ needs, and even his siblings.
he was visibly distraught with how his parents were suffering and how he had contributed to their pain


Danny also became less introverted and eventually found a decent-paying job, where he developed friendships with several of his coworkers. A few months later, he said, “If I’m being honest, I’m not doing that much more to help anyone, but even thinking about other peoples’ needs has given me much more perspective. I have more interesting conversations with people now. They open up more since they see that I’m focused on what they’re saying, and that I care about them. Even my conversations with my siblings are better.”

***


As my work with Danny illustrates, interpersonal connection requires noticing other people’s needs with true sensitivity. Doing so enhances our ability to help them when they do not explicitly ask for our assistance. Furthermore, the importance of noticing others’ needs goes beyond improving their wellbeing; our own connection benefits as well when we develop finely-tuned empathy for other people.
 

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Bios
David H. Rosmarin David H. Rosmarin, PhD, is an assistant professor in the Department of Psychiatry at Harvard Medical School, and director of the Spirituality and Mental Health Program at McLean Hospital. Dr. Rosmarin’s new book, The Connections Paradigm: Ancient Jewish Wisdom for Modern Mental Health, is now available from Templeton Press.