The Importance of Being Present

Lori McIssac Bewsher

Being present might be the most important and equally undervalued resource that helpers and counsellors have to offer. However, it can be difficult to be present when we feel like we don’t have the necessary experience to be effective in our roles.

Early in my social work career, I was offered a position working in a hospital and learned that I would be assigned to patients receiving end-of-life care on a palliative unit. My panic set in almost immediately. What if I said the wrong thing to someone dying? What if I was too emotional to manage their pain and distress? How would I deal with all the grief and loss?

Being present might be the most important and equally undervalued resource that helpers and counsellors have to offer.

Even though my social work degree prepared me to work with people experiencing a variety of situations, I suddenly felt like I had missed the whole chapter on death and dying. I felt completely unprepared for a job that I had the basic qualifications to do but none of the knowledge or experience I thought I would need to be effective in the role.

Fortunately, I spent almost eight years working in this position and I quickly gained the knowledge I needed to be competent. I learned everything a social worker might need to know about end-of-life medical care, medications, and treatment options. I became skilled in helping my patients and their families access the supports and services they would need both during and after the dying process. However, the most important thing I learned from this experience was the tremendous gift of being present.

Sitting in Discomfort

Although my immediate reaction to accepting this position was to learn everything I could and become an “expert” in the dying process, I soon realized that the patients would teach me the most. Many of the people in my care just wanted someone to confide in. They weren’t looking for information or details on what to expect – mostly they wanted to talk about their lives, their legacies, and their hopes for a peaceful death.

My patients would often express that they didn’t want to talk about their approaching death with their families as it was too painful for their loved ones to hear. But with me they were free to wonder aloud about what their life had meant to others and their hopes for their families after their death. My accomplishment was not in everything I was learning to do but in my ability to sit with a dying person who just wanted to be seen and heard – even when it was uncomfortable.

The Assumption Trap

It’s safe to say that most helping professionals carry a strong desire to assist others by relieving their suffering. That’s why so many of us have chosen to enter this field. We care about people, and we want to have a positive impact on their lives and functioning.

However, this desire can work against us if we are not cautiously aware that what we want often drives the counselling relationship. When we view ourselves as the owner of the “help” that is bestowed upon our patients, we run the risk of making assumptions about the type of help that is needed and our responsibility to deliver it.

When we are truly able to be present with someone, we are tuned in to listening to their words and stories.

When we are truly able to be present with someone, we are tuned in to listening to their words and stories. We allow ourselves to be curious about their experience and develop an understanding built from their perspective rather than our own. If we jump too quickly into planning what we believe they need from us, we may completely miss the opportunity to intervene in the most meaningful way.

Modelling Behaviour

When we are truly present in our helping relationships, we are also modelling behaviour that our clients can take into their other relationships. Presence is a healing intervention that goes beyond our words or acts of service. People generally begin to heal when they experience the felt sense of a presently engaged nervous system in response to their own.

There is a ripple effect experienced between two individuals when calmness is shared from one person to another. In a world where productivity and busyness are often valued over rest and relaxation, it can be difficult to slow down long enough to be truly present. This is one of those concepts that we learn best through our own experience, and we must learn how to regulate our own system into presence before we try to share this with others.

Presence is a healing intervention that goes beyond our words or acts of service.

Healing From Within

Presence as a clinical intervention also provides the space for others to begin to heal themselves. Even if you are a highly trained and experienced helping professional, healing will not occur until your client’s system is ready to transform.

A positive therapeutic relationship is an important predictor of successful outcomes in therapy. Safety, trust, and presence are essential ingredients in any helping relationship. When a client makes a connection or gains an insight in a conversation or session, it is not usually the direct result of our words or reflections. Rather, it comes when the client feels safely supported in the presence of a caring helper.

As helpers, it is normal to feel helpless or underqualified to manage the problems of the people we care for. Although we may yearn for more years of experience and have a strong desire to act and resolve the distress of our clients, it is important to remember that our ability to be present is one of our greatest assets in any helping relationship.


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Author: Lori McIsaac Bewsher (MSW, RSW)
Trainer, Crisis & Trauma Resource Institute

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