Generativity and Recovery! Part Three: Dismantling Industry Constructs to Make Generativity Possible

When I think back to my twenty-two-year career working with other providers, my mid-career first-break, and the things that helped me recover, like my dog, I know for sure that the standard of care needs is a disservice to those who experience madness.

Many people who have breaks from reality get that permanent housing trajectory in their heads and rant and rail against it. They may still believe that there is such a thing as schizophrenia and be disinterested in the lives of their peers who are clearly schizophrenics. Those who have breaks, like me, are extremely diverse with distinctive cultural backgrounds, different access to resources and differing levels of buy into to the concept that they are permanently ill with something that will never go away. Those without a history of privilege become very susceptible for decline into permanent warehousing conditions that make healing very challenging.

Clearly, dismantling industry constructs for things like schizophrenia and poor prognosis is an important component of recovery. I have a hunch that to plan for generativity, schizophrenic constructs, other disorder constructs that block the formation of counterculture, and constructs from developmental psychology need to be challenged.

 

 

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Generativity and Recovery! Part Two: Generativity in My Own Recovery

My three-month psychiatric incarceration seemed to be aimed at discrediting me after I had leaked newspaper stories. On my way to Canada to seek asylum, I was stopped by police. I evaded them for three days through rural towns and surrendered one midnight, from a ditch on a mountain pass.

It was hard for me to accept the way I was treated. Confined to a ward for two weeks, I walked in circles. I barked on the payphone testing many of my supports. They all just said I was delusional.

I really did learn a lot from a mob boss’s daughter. There are a lot to the rules that govern those of us who get trafficked in this land of the free. Still, I did what I could to disrespect the mob especially because my counselor told me not to. And so, I endured a month of chronic warehousing conditions. I had to wear other peoples’ clothes to brave the ice-cold of the barely heated ward.

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Generativity and Recovery! Part One: The Need to Plan for Generativity from the First Break

 

In the United States, when a person has what is often referred to as a first break, the courses of action that get taken against them may end up being a crime against their humanity.

While there can be very diverse responses from family and friends, there is the unfortunate tendency to turn to the mental health industry for support and direction. Many providers in the industry only know the standard of care which is to refer the person to a hospital and psychiatric medications.

Few providers take an interest in understanding and exploring the important experiences that lead to the break. I call these experiences special messages. Finding a provider who is curious about these experiences, skilled at understanding them, and who knows better than to try to suppress them can be rare.

Many providers fail to acknowledge the trauma involved in the lives of the people who have first breaks and that the trauma that gets worsened as the standard of care—forced medication, social security, revolving hospital doors, and warehousing—get implemented. Many presume this is a necessary process.

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How to keep “Psychosis” Focus Groups Inclusive:

I fervently believe that having survivor-led group therapy that redefines “psychosis” is missing in the system.

Over the last nine years, I’ve been leading what I call special message groups in multicultural settings. I have found that such groups can be run safely and have the power to transform lives. However, I do admit that when it comes to kicking people out of group to maintain group equilibrium and safety that I believe there are a few things to consider first.

Firstly, I believe that a group leader needs to be prepared for the fact that mad people show up in very different ways. Group facilitators need to be familiar with and recognize a wide variety of presentations or manifestations. Perhaps group members may feel like they are being mocked by others in the group via illusionary ideas of reference or even controlled by them. They may code up their language for protection. They may treat the facilitator as if the facilitator can hear the same voices they hear. They may not believe, in spite of stories shared, that the facilitator has experienced what they have.

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Writing for Mental Health: Six Basic Considerations

I like to think that I could recommend writing to some other people who have been subjected to a diagnostic labeling process that diminishes their hopes and potential. Indeed as emotional tension pulses through my back and appendages, I have found few other outlets that are there for me like the mixing and mastering letters.

Sure, I have been sent to a shrink for being who I am. Sure, I have been buried in institutions at different points of my life. Indeed life on that trajectory has filled me with loss and lack. But when I’ve found myself incarcerated immobile, I’ve been blessed to find value in defining it. Initially as a teen, I found  appreciating expressive words through music got me started. The more I switched from song to verse to story, I found the problem-solving that takes place in the editing process satisfying. Indeed for me there are few other outlets that rival writing in terms of learning about life and wellness.

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Letting the Public Know I Suffer from Schizophrenia

When people seek mental health services from me, I routinely break what was once a cardinal sin to me early on in my recovery; I review my diagnostic history. I do this with love in my heart to help inspire recovery, however, in the process, the “s” word, “schizophrenia,” will bubble up.

I do this habitually in the outpatient program I work in. I have done this by redefining the medical model definition of the word so that it more accurately reflects the shared internal process that we with “schizophrenia,” or “schizoaffective,” or “bipolar,” or “depression,” or hosts of other diagnoses experience.

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The Special Messages Project

LEARNING QUESTIONS

Learning Question One: How do in-reach efforts that connect residents of board and care homes, single room occupancy (SRO) hotels and unlicensed boarding houses to social and recreational opportunities in and outside of the facility reduce social isolation and improve quality of life for isolated adults and older adults with serious mental illness?

To answer our first learning question we used several strategies to obtain participants who receive special messages from SROs and Board and Care homes.   Initially, we envisioned providing individual services to people who responded to flyers and presentations in board and care homes and SRO hotels; however we found we had to adjust our strategy.

Instead our strategies included:

  • Passing out flyers to locations where residents in these locations are likely to frequent;
  • Direct emails to the board and care and SRO facilities;
  • Partnering with three social service agencies (PREP, East Bay Recovery, and Bonita House) and providing presentations and groups at those sites;
  • Partnering with Gladman Hospital, a long term inpatient settings, and providing presentation and groups at that site;
  • Outreaching to the homeless population;
  • Presenting at Saint Vincent De Paul Shelter, the Pacific Care Senior Center; the Fairmont Partial Hospitalization Program, and to Villa Fairmont Inpatient Hospital;
  • Coaching board and care staff;
  • Working with families.

The Program Manager pointed to safety issues associated with marching directly into board and care homes and SRO settings and providing groups. Indeed our trainees were transitioning into peer support experiences and promoting safety was paramount.  Instead, we initiated the process of gaining visibility in the community and training via general outreach. Next, we outreached to the homeless and practiced using our stories and strengthening our presentation skills. Once we started presentations and got invited to conduct groups in more staffed and protective settings, the trainees ran groups and initiated one on one relationships with individuals who were receptive.

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Towards More Honest Ways to Teach Counseling Theories

I’d like to think that if therapists like me who have been farting around with psychotherapy for twenty years or so, might be able to improve the way counseling theory is taught in graduate school. Ideally, I would like to support the development of theory that address social ills. I have found myself feeling this way when I think of all the different misconceptions that I have endeavored in over the years. Now that I have established my niche and am advocating for new movements and theories that make most sense to me, I am finding myself wanting to help budding therapists learn how to conduct the art of psychotherapy in ways that help solve pressing issues, not just apply a scientifically proven technique or pass a test.

I think psychotherapy has made a break through to some extent that doesn’t get talked about. More and more theory is being constructed that help therapists solve problems rather than exhibiting panacea proclamations. I consider panacea theory to be what I was taught in graduate school: in its most postmodern form it includes narrative and solution focused therapies. Panacea theory was often remiss to really address social ills as they exists in agencies and on the ground. I think the onset of what I would call problem-centered approaches began with movements like DBT and Motivational Interviewing.

 

Problem-Focused Therapy instead of Panacea Therapy:

And I think if we look at what works about the problem-focused therapies that already exist, we can learn a lot about not only about how to solve real social problems, but also how to create theoretical elements that actually help teach other therapists in ways that enhance their art of psychotherapy.

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When Mad People Become More Mindful of Their Culture

I am convinced that amazing growth can occur when mad people come together and share their mad experiences in a safe and inclusive arena. Over the past eight years, I have led group therapy and trainings that go towards mad experience to explore it further. I have found that in listening to very unique mad stories that cultural themes start to emerge from vastly different kinds of experience. If each kind of mad experience is like a letter in the alphabet, put them together in vastly different lives and the likeliness of unique experience becomes immense. But helping people identify mad experiences and cultural themes in themselves and in others has led me to conclude that in reality we belong to an oppressed culture.

Once participants in groups that I have led learn that they belong to what I suggest is a culture, they start to look at their own stories in a new light. The level of trauma decreases and the flexibility and social functioning increases. In effect, I am convinced that learning more about other peoples’ mad experience and cultural themes in general has many positive effects.

 

Creating Safety and Inclusion in a Group:

For years I operated groups without delving into the details of madness. I concealed my own mad experiences, reasoning that I was not in a safe climate. I had a paycheck to earn. However, once I became licensed, I was introduced to WRAP. I started to take the necessary risks and found not only that there was a whole world of good that I had been missing out on. I was wrong about the safety issues in the group. I found the experience of defining madness with the mad to be inherently safe, but have developed and documented my own style of keeping things safe.

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Three Ethics to Consider when Making Money off the Mad

Making money off the Mad is not a privilege to take lightly when one believes in recovery.  Many of the Mad in the system, depending on how much experience they have, will presume you’re going to treat them like a commodity or property as many provider-folks have done previously in their history. I believe that a large part of gaining trust involves demonstrating that the best interest of the Mad person needs to honored above and beyond the money made.

When I first set my eyes on being a Mad-Recovery-Provider about twelve or thirteen years ago, I saw a lot going on that was not honoring this principle. The level of alienation I felt between myself and other providers was very high. I became effective at managing this aspect of the therapeutic relationship and achieving trust.

As time has moved forward and I have seen the amount of recovery lost to unhealthy clinical families, failure of providers to collaborate, and interagency and interdisciplinary infighting, I have changed my perspective.

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