What exactly is support?

by TheEditor

Categories: Investigative, Mental Health

Over the years I have come to appreciate that patients in psychiatric services very much value support. I’ve been wondering ‘What does support mean?‘ Hold on – I know that everybody knows support when they feel it. That would not inform me what aspects of support make it real or valid. Mental health workers and services without doubt need to provide support. Support can vary across various types of activities e.g. emotional support, advice, guidance, therapy etc. That does not tell me anything about how people actually come to feel supported.

Support is both something provided and also something felt by the person being supported. How does the feeling of being well-supported come about? That set me to an exploration. Note the (click) words of caution below.

Fundamental concepts

Support in the human context is a broad concept that encompasses a variety of ways people help each other to navigate life’s challenges. There are some fundamental concepts that apply to any kind of support:

  1. Validation: Feeling supported often involves feeling understood and validated. This can come in the form of empathetic listening, affirmations, or simply acknowledging someone’s experiences and emotions. This is fundamental in all kinds of support.
  2. Reliability: A person feels supported when they know they can rely on the support system in their times of need. The support system can include friends, family, mentors, or even institutions. The reliability can be in the form of consistent emotional support, financial stability, or resources.
  3. Empowerment: Support is not just about providing help, but also about empowering the person to manage their own situation. This can mean providing them with the tools, resources, or skills to address their own needs. In a psychological context, for example, it might involve teaching coping strategies. In a financial context, it could involve teaching money management skills.
  4. Accessibility: Support needs to be accessible to the person in need. This means it is available when and where they need it, in a form that they can use. This could involve ensuring that resources are understandable and usable, or that emotional support is offered in a way that the person feels comfortable with.
  5. Respect: Support should always respect the autonomy and dignity of the person receiving it. This means acknowledging their capacity to make decisions for themselves and respecting their choices, even when offering advice or resources.
  6. Adaptability: Support needs to be flexible and adaptable to the changing needs of the person. What’s supportive in one situation may not be in another, and support may need to evolve over time as the person’s situation changes.
  7. Encouragement: Encouragement is a key element of support. Whether it is verbal affirmation or through actions, encouraging someone can help them feel more confident in their ability to overcome the challenges they’re facing.

These principles apply across different types of support, and understanding them can help you provide more effective support to others. However, it is also important to remember that everyone is unique, and what feels supportive to one person may not to another. Good support involves listening and understanding the specific needs and preferences of the individual.


The above fundamental concepts must rely on a larger foundation and structure. I came up with the following:

Honesty and Trust

Readers may have observed that honesty and trust are inseparable when one thinks about reliability and respect. Honesty and trust are fundamental foundations of integrity in our personal and professional relationships. They are deeply intertwined and reinforce one another in a continuous loop, each one nourishing and amplifying the other.

When we think about support, whether it is emotional, physical, financial, or any other type, the presence of honesty and trust amplifies its effectiveness. Here’s how:

  1. Honesty in Support: Offering support begins with understanding the needs of the person we’re helping, which requires open and honest communication. The person providing support should also be honest about their capabilities and limits to set realistic expectations. On the receiver’s end, honesty helps articulate the type and extent of support needed.
  2. Trust in Support: Trust is crucial in accepting and providing support. People need to trust that the support offered is genuine and reliable before they can fully accept it. Similarly, the person providing support must trust that the receiver is sincere in their acceptance and will use the provided support effectively.

Honesty creates transparency in the supportive relationship, ensuring that the support provided aligns with the actual needs. It helps eliminate misunderstandings, enabling the support to be more targeted and effective. It also reinforces respect, as honesty involves recognising and honouring the other person’s experiences and needs.

Trust, on the other hand, creates a safe space where individuals feel comfortable expressing their vulnerabilities. It enhances the feeling of reliability and consistency, critical elements of support. When people trust that the support they receive is consistent and dependable, they feel more secure and capable of facing their challenges.

So, when honesty and trust are present in a relationship, the support exchanged becomes more meaningful, effective, and beneficial. They are like the strong roots that enable the tree of support to grow and thrive, withstand storms, and continue to provide shelter and nourishment.

At its core, honesty is about being truthful, transparent, and genuine in our thoughts, words, and actions. It is about not only speaking the truth but also living it, aligning our actions with our words. Trust, on the other hand, is the firm belief in the reliability, truth, or ability of someone or something. It is the confidence that someone will act with integrity, that they will be there when needed, and they will do as they say.

Honesty acts as the cornerstone in the establishment of trust. When we are honest, we create an environment of openness and transparency. We signal to others that we are reliable and authentic, that our words match our actions, and that we won’t manipulate or mislead them. This fosters a sense of safety and predictability, which are essential for trust to thrive. The interplay between honesty and trust indeed forms a fundamental foundations of support. These two elements intertwine to create a supportive environment where individuals feel safe, understood, and valued.

In turn, the presence of trust encourages honesty. When we trust, we open up, becoming more vulnerable, sharing more of our true selves and our true thoughts. This openness further invites honesty – as trust indicates a safe space where truth is valued and respected.

Together, honesty and trust create a powerful dynamic that deepens connections between people. In personal relationships, honesty and trust allow for intimacy and understanding to flourish. We feel secure, understood, and valued when we are in a relationship where honesty and trust are present. We are more likely to share our true feelings, to seek support when needed, and to provide it when we can.

In the professional realm, a culture of honesty and trust can lead to increased cooperation, productivity, and job satisfaction. Teams can work more effectively together, and leaders can inspire loyalty and respect. Honest business practices build trust with clients, customers, and stakeholders, which can ultimately lead to long-term success and reputation.

However, both honesty and trust are fragile. They take time and consistent effort to build, but they can be damaged quickly by dishonesty or betrayal. Once broken, they can be difficult, and sometimes impossible, to fully restore.

In essence, honesty and trust are intertwined like strands of DNA, each one supporting and amplifying the other. They form the ethical double helix that keeps the molecule of human relationships stable, healthy, and resilient. Without one, the other cannot exist. Together, they create the foundation upon which we build our relationships, our communities, and our societies.


Empathy: The ability to understand and share the feelings of others is a fundamental pillar of support. Empathy allows us to tune into the emotional experiences of others and offer comfort or assistance that is truly aligned with their needs.

Open Communication: Clear and open communication facilitates understanding between the person offering support and the person receiving it. It ensures that needs, boundaries, and feedback can be shared effectively and without misunderstanding.

Patience: Providing support often requires patience. Changes and improvements may not happen immediately, and the person receiving support may need time to process their feelings, try out solutions, or make decisions.

Kindness and Compassion: Kindness and compassion are central to providing emotional support and making the person feel valued and cared for. They also encourage a non-judgmental environment where the individual feels free to express their vulnerabilities.

Resilience: Support often involves helping others to overcome challenges or navigate through difficult times. Having resilience, both in terms of the person providing support and the person receiving it, allows for persistence in the face of these difficulties.

Words of caution

Therapeutic relations

A word of caution: not all therapies and therapeutic relationships provide support in the same ways. The type and level of support provided in mental health services and counselling can vary widely, depending on the therapeutic approach, the goals of the therapy, the nature of the issues being addressed, and the preferences and needs of the individual seeking therapy.

Cognitive-Behavioural Therapy (CBT) is a clear example of this diversity. CBT often focuses on identifying and challenging dysfunctional thinking patterns and beliefs, developing coping strategies, and fostering behavioural change. The therapeutic relationship in CBT may prioritise collaboration, education, and skill-building. While this approach can certainly be supportive and encouraging, it might not always delve into deep emotional exploration or provide the kind of emotional nurturing found in other therapeutic modalities.

On the other hand, therapies like psychodynamic therapy or humanistic therapy may prioritise understanding unconscious processes, exploring emotional experiences, and building a deeply empathetic and validating therapeutic relationship. These approaches might provide more profound emotional support, allowing for a more intense exploration of emotional wounds, relational patterns, and existential concerns.

The differences in support across therapeutic modalities can also be linked to the different foundational pillars emphasised. In CBT, the emphasis might be on honesty, open communication, and collaboration, with the aim of fostering self-reliance and coping skills. In more emotion-focused therapies, the emphasis might be on empathy, compassion, and deep emotional connection.

Ultimately, the type and depth of support provided in therapy are shaped by the therapeutic approach, the unique needs and goals of the individual, and the expertise and style of the therapist. It is an intricate interplay that makes each therapeutic relationship unique and tailored to the individual’s specific situation. Therefore, selecting the right therapeutic approach and therapist often involves considering what kind of support is most needed and aligning that with the available options.

Non-therapeutic relations

Non-therapeutic relationships such as ‘friendships’ or close associations may vary quite a lot in the kinds of support they might provide. Not all non-therapeutic relationships are built on ‘support’.

At another end of the spectrum: some kinds of business relationships are built on strict contractual terms and conditions, with clauses for redress or exit conditions for breaches. One does not expect to find emotional support from a business relationship. Whilst nearly all human relations depend on honesty and trust, the extent to which they rely on those foundations vary quite a lot.


This exploration led me to find that honesty and trust were the cores of support, in therapeutic relations. Honesty and trust form a fundamental dyad that serves as the foundation of support in human relationships. Honesty, a commitment to truth in thought, word, and action, cultivates an environment of transparency. Trust, a firm belief in someone’s reliability, truth, or ability, blossoms in this transparent environment, establishing safety and predictability. Together, they create a dynamic that deepens human connections, fosters intimacy, understanding, and forms the basis of any strong relationship, be it personal or professional.

Moreover, honesty and trust play an integral role in support mechanisms. Honesty, in understanding and addressing the needs of the individual receiving support, and trust, in the reliability and authenticity of the support provided, amplify its effectiveness.

Empathy, respect, open communication, patience, kindness, compassion, reliability, and resilience also build the ‘house’ of support. Empathy and kindness enhance understanding and comfort, while respect and open communication facilitate a safe, equal space for interactions. Patience and resilience foster endurance in the face of adversity, and reliability provides a sense of security and stability.

In essence, the interplay of honesty, trust, and these additional elements forms the basis of supportive relationships, creating a rich, multidimensional framework where individuals feel safe, understood, and valued. Each of these components, acting in concert, cultivates an environment where effective support can be exchanged, making them crucial elements in the fabric of human relationships.

Whilst my exploration was wide and deep in finding core components of support, it must not be assumed that all therapies and therapeutic relationships are built on all of them. Some therapies like CBT are different to more emotionally focused therapies. Nonetheless, therapists, psychiatrists and patients can benefit from a better understanding of the concept of support. It is for each patient and mental health professional to delineate how their therapeutic relationship will function.

Non-therapeutic relations do not necessarily aim to provide emotional or practical support. Caution should be exercised in generalising from this article.

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