The approach of exploring ways to achieve a peaceful mind, even if the suffering could be perfectly resolved, was derived from severe clinical settings such as relationships with people who were near death. Our workshop is unique compared to those held by medical staff because:
・The contents can be learned together by various occupations, such as care workers and general citizens, and are not exclusive to workers in the medical field.
・We place great importance on role-playing. In addition to knowledge acquisition, we emphasize practical use of such knowledge in the real world.
・The session helped participants to not only learn interpersonal assistance but also build resilience.
・The learning skills are practical and can be applied in daily life and work.
・By using the unified teaching materials, instructors can conduct repetitive high-quality workshops.
The content that is emphasized the most in the workshops was classified into three themes.
1. Realization of support in suffering
Suffering can be defined as the “gap between hope and reality.” This includes suffering that can be resolved and that cannot be resolved. Suffering that cannot be resolved involves problems that cannot be fixed by explanation or encouragement (e.g., “Why am I alone ...” or “I want to disappear if I’m annoying people”). Support offered for unresolved suffering can help the patient feel at peace. The three types of support are “supporting relationships,” “freedom to choose,” and “future dreams.”
2. Expressing support verbally
The most important theme is that suffering people are happy to have someone who understands their suffering. What kind of person is someone who can understand others? It is a person who can silently listen to another person’s words.
The tenets of effective listening are repetition, silence, and asking. The objective of the supportive communication was not to understand the other person perfectly but to lead suffering people to think of supporters an understanding people.
3. Accepting and cherishing oneself
We can praise ourselves when we help someone; however, life is not so simple and easy. It is very painful to feel “not needed by anyone” without being able to help anyone. In such a situation, try to be aware of the relationship with and support from someone who accepts you as “good enough.” Feeling that we are good enough, even if we are not very good, can help build our confidence to live. This qualitative study revealed the participants’ change in perceptions, emotions, and learning processes after the ELC workshop based on Kolb’s ELT.
In this qualitative study using reflective journal writing, some of the participants showed actual behavioral change, and the participants reported that they thought that some of the techniques were also effective for the suffering people After providing supportive communication to people experiencing suffering that was difficult to solve, using the techniques of repetition, silence, and asking, we found it was possible for them to express their suffering more clearly.
One of the participants was able to help a young terminal cancer patient admit that they were afraid to die, and to share their suffering; this might help the patient experience a peaceful death. Another participant reported that her mother’s frequent phone calls and complaints had stopped after the participant had used supportive communication. Furthermore, many participants could ease their sense of weaknesses, and they were willing to get involved in helping suffering people confidently. These tendencies were also observed during the survey conducted three months later. Therefore, these results indicate that changes in consciousness and behavior might be brought among the participants.
We would like to emphasize the need to apply these techniques in the real world, particularly in the workplace. We anticipate that in the coming era, a large number of people will struggle with absurd and inexplicable suffering and that the number of people who can confidently support such suffering people is overwhelmingly few.[10][11][12] Therefore, we propose that people in all professions, including those working in healthcare, should learn the basics of interpersonal assistance and continually learn in real-world workplace environments. We believe that if each person can continue learning based on the basic principle—that people with suffering can also be happy if they have somebody who can understand them and their experience—the number of high-quality supporters will increase [6].
It is important to hold repeated workshops rather than offer only one session. In fact, we found that, even during reflective journal writing, the participants’ techniques were firmly established and their understanding was deepened by repeated participation in the workshops.
Alfred Adler, a psychiatrist and psychologist, proposed the acquisition of a “community feeling” as a condition for all human beings to live happily; the essential elements for achieving the feeling of community are self-acceptance, interpersonal trust, and contribution to people and society. “Accepting and cherishing oneself,” one of the important themes in the learning program in this study, can be considered as closely related to the idea of self-acceptance in Adler’s psychology [13]. In addition, in the fifth habit of Stephen R. Covey’s masterpiece, “The Seven Habits of Highly Effective People”, he emphasized the importance of “trying to understand the other person first;” it also endorses the method of repetition discussed in this study[14]. Thus, the supportive communication performed in our workshop has already been suggested as a useful tool for end-of-life patients and building trust with the other person in daily life [15]. Furthermore, some reports show that a connection with people who sympathize with suffering people has helped prevent suicide and burnout [15][16].
There are several limitations to this qualitative study. First, we obtained few responses in the follow-up survey largely because we could not collect participants’ contact information at the end of the workshop. Since follow-up surveys are important for establishing the effects of learning, we need to take an effective step to set expectations for follow-up surveys before holding the workshop. Second, although our approach was not as rigorous a method of qualitative research than other approaches and we had a limited number of participants, the content of the discussion and the reflective journals were very rich and reached data saturation. Third, since pre- and post- test analyses were not conducted to evaluate the participants’ actual ability, we were unable to establish objective causality of the effectiveness of the study. However, applying the Kolb’s ELT to the content of the reflective journals, most participants seemed to express reflective observation (step 2) and abstract conceptualization (step 3). In addition, some of the participants seemed to reach the active experimentation (step 4) in the self-evaluation 3 months later [7].
The purpose of the present workshops was to learn how to deal with the problem of suffering, which all human beings experience. Many people are becoming isolated and experience inexplicable suffering during the COVID-19 pandemic [17]. Thus, practices that can enhance resilience in a society are expected to become more important in the future. The results of this study can be used to build resilient communities that are designed to facilitate close relationships and allow people to provide assistance to those who are isolated and to help others feel at peace in the face of unsolvable suffering.