The Meaning of the Sacred Watch Validating before Redirecting

Written by Nettie Harper & Kelly Gilligan, Co-Founders of IMC

This is the story of a sacred watch and the lady who held it close to her heart.

Kelly and I received a call for a client (we’ll call her “Betty”) and were excited to make a new connection. However, the family was painting a bleak picture of Betty, warning us about the challenges their mom presented, and how reactive her behavior could be. After hearing their stories, I had a picture of a big black bear on its hind legs with its claws drawn and mouth wide open, ready to charge at me!  It was clear the family had been through a lot, but we were confident we could help.  

We gathered as much background information as we could.  Then, after a week of preparation, it was appointment day.

Kelly and I checked in at the front desk at the senior living residence where Betty was residing. Her daughter had planned to greet us in the lobby in order to facilitate our introduction, and was ominously missing.  We made our way to the apartment, where we knocked a couple of times and rang the doorbell too.  There was shuffling behind the door.  After a bit, we were greeted by a frantic aide, then by Betty’s daughter proclaiming, “this is not a good day,” and then finally by Betty.  She was red-faced, crying and yelling.

After gaining permission from Betty, I walked in, spoke directly to her and matched her tone, exclaiming, “tell me what is wrong!”  

Betty proceeded to accuse her aide.  Angrily pointing in the lady’s direction, she shouted, “I told her to watch my watch! Now it’s gone.”  The aide stared back, speechless and teary-eyed.

I tossed my bag on the floor and said, “Let me help you find it, but first, please let me get you a chair to catch your breath.”  

We settled Betty into the chair, and Kelly began asking open-ended questions about the watch.  “Tell us about this watch,” she asked, “It’s very important to you?” Betty slowly started calming down, quietly describing the watch and then moving into its significance.  When Betty referred to the watch, she expressed it’s meaning, stating, “my husband, Hank, gave it to me off his wrist before he passed . . .”

Kelly rephrased, “that watch is the last thing he gave to you and now it’s missing. You must be so upset.”

She responded, “yes!”

We replied with an open-ended question, “Hank was very dear to you.  Will you tell us more about him?”  

And she did.  We spent five minutes with Betty sharing her admiration of Hank -- her great respect for his ability to “read everything in sight!” and his willingness to share his knowledge with her.  Betty had survived Auschwitz, and it was clear Hank was a symbol of love and safety in a disordered world.  The watch was a symbol of Hank.  Both were gone and Betty was feeling a sense of loss and vulnerability.

We continued to actively listen to Betty as she expressed her grief.  She then engaged us in a viewing of a spectacular portrait of her and her husband.  His gaze toward her was tender.  “Look how he watches over me!”  

Betty smiled as she shared details of their life together.  She mentioned that she and Hank enjoyed music.  We took this as our cue to transition to a subject that could continue to bring out the smile and joy in Betty, and were able to proceed with our Skills Discovery.  

Betty’s aide and daughter continued searching for the missing watch, occasionally peeking out at the laughter in the living room.  Kelly and I spent an hour and a half connecting with Betty over “Singin’ in the Rain” (a movie she had seen with Hank), asking advice about art and relationships . . . And as our session drew to a close, we heard a big cry.  It was Betty’s aide and daughter. They had found the watch, in the drawer where it was supposed to be kept.  They had been feeling so tense, frantic, and emotional that they had missed seeing it there several times.  

Our new client was not a big black bear with claws, she was a gentle woman who needed to be heard and to grieve her losses.  Is this dementia?  Or is this natural human behavior?  When you next have a loved one or client that is having a bad day, pause and listen.  If you jump into redirection you will miss what he or she is trying to communicate.   You will miss the connection.

A Bit About Validation:

When individuals with memory impairment feel emotions, they do not always have the ability to regulate their expression and behavior according to social cues.  However, that does not mean that the emotions aren’t real.  It can take tremendous patience to validate another person’s emotions (especially ones that are repetitive or that are negatively expressed at you); however, doing so just a few times builds trust, and trust is at the crux of every relationship.  The basics of validation are:

• make eye contact and maintain it
• match your expression to the emotion conveyed (ex. In Betty’s case concern)
• rephrase what the individual is saying so that he or she knows they’ve been heard
• ask open-ended questions, use music, or even movement that helps the individual express what he or she is feeling.  Some verbal prompts can include, “tell me more about . . .”

“Is there ever a time when you don’t feel this way . . .”

“What’s the best/worst thing about . . .”

• avoid using sympathy or saying, “I know how you feel.”  It’s not about fixing.  It’s about presence and active listening.  

Kelly and I were able to validate Betty’s feelings by using the steps above.  By listening to Betty we were able to guide Betty into connecting with us and sharing in meaningful, joyful experiences.  By the time the sacred watch was found Betty had moved through her emotions and was able to connect without the watch.  Although Betty, the aide and daughter were truly relieved to have found the watch.  Hank was close to Betty again!