How to Hold Someone in Unconditional Positive Regard

Unconditional positive regard (UPR) is a concept created by humanist psychologist Carl Rogers. Death doulas practice UPR with their clients. So this means we must accept a person just as they are, with no conditions. I know what you’re thinking. Even Eagles fans? Yes. Even Eagles fans. But how to hold someone in unconditional positive regard? And why?

What a person says or how they behave doesn’t change the way a doula works. For example, a client can be in a bad mood, act out, or insist that ketchup goes great with steak. It can be difficult, but we must look and act with love and compassion.

As end-of-life doulas, we must hold them in positive regard unconditionally.

This isn’t always easy

Sometimes clients might share with us some views we find horrific. Perhaps a dear old woman reveals that she had harmed her children, years earlier. A kind man is filled with regret for the crimes he committed in his youth.

Putting that negative reaction aside can feel strange. Almost like we are betraying a code of ethics or values. A part of ourselves.

But for a doula serving someone at the end of their life, UPR is vital.

Years ago, I worked with someone whose political views clashed with my own. She believed in ideas that had been proven false, time and again, yet she clung to them in a way that seemed petty and cruel.

Holding her in positive regard was one of the most challenging professional moments of my life. I had to practice neutral smiles and think happy thoughts, concentrating on the good work we were doing together rather than what she thought about world affairs.

It required patience and understanding.

Here’s what UPR doesn’t mean

Unconditional positive regard doesn’t mean we’re friends. It doesn’t mean death doulas feel a connection or even a bond with the client.

Positively regarding someone doesn’t imply we condone their actions or beliefs. There is no approval process happening.

It helps to remember that, like so much of our work serving those at end-of-life, this isn’t really about us. This work is about the client and their needs.

Focusing on them, rather than our opinions is helpful when switching that UPR button on.

And keeping it there.

Self-care y’all

Doulas can support someone without agreeing with them. We will have good days and bad days, but overall we can do positive work without feeling negative about people with whom we have opposing beliefs.

Here are some ways to help us get there.

Separate the person from their actions.

Look into their eyes. Hold their hands. See their humanity. Smile. Be present in the moment, rather than thinking about what bothers you.

Find a mentor or support group.

You can keep the details to yourself, and maintain your client’s privacy, but talking in general to someone, even a therapist, can help you feel better.

Let go and stop judging yourself.

Are you expecting too much? Try closing your eyes for a moment to breathe. In and out. Let go of any expectation you have to be super-human. Treat your thoughts with nonjudgmental unattachment.

Unplug for a bit.

Perhaps the news or social media is contributing to your negativity in some way. Therefore, try taking a break and see if that helps.

Read some books about UPR.

Many doulas, therapists, and spiritual leaders have gone through what you’re experiencing. As a result, their words can inspire.


Running, a fierce workout in the gym, or a simple walk around the block. Preferably outdoors during the day. Soak up some vitamin D.

Take a vacation.

Burnout is real. Taking a true break, where you relax and savor the joy of family or friends, can help us think better about everyone else.

Sometimes, for people facing the end of their lives, they need a supportive presence to explore themselves. And to think about the choices they’ve made. The mistakes. The triumphs.

In short, learning how to hold someone in unconditional positive regard works to provide a more peaceful transition. For everyone. No matter who they are. Contact Anitya Doula Services for more information.

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