Summary of My Training in Six Hours, Tailored to your Worksite

Description

Educational Objective:

Historically, clinicians are trained to avoid engaging with people when they are in an emergency state for fear of escalating symptoms. However, is this escalation more the result of the recipient feeling judged and their suffering invalidated, than the implicit wrongness of exploring these experiences? Is it possible to learn to listen with open hearts?

Given six hours, I provide an introduction to my 20 hour training that is aimed at establishing a road-map to the rabbit-hole, The goal is to help recipients be better listeners and more motivated to join with participants in examining experiences associated with “delusions,” “alternative realities,” or extreme states of consciousness.

My larger workshop redefines what is happening during a person’s journey through madness in a structured way that justifies intervention and highlights solutions.

This shorter presentation is designed to can help a clinician feel confident that listening and intervening has value and can be necessary to form an alliance. The focus is on message mindfulness or paying more attention to the internal processes that must be experienced accepted and ultimately emotionally contained to engage in social rehabilitation. It is awful hard to achieve message mindfulness when message receivers are not allowed to speak of, or supported to examine, those internal processes

This presentation is intended for all levels of trainees. It may also be helpful to family members. Parts of it are introductory and parts are advanced. It is intended to inspire clinicians to bravely address the issues that are experienced in a psychotic break or what becomes redefined as a special message crisis.

I have written multiple drafts of a book to guide me in the development of this redefinition of psychosis. for more advanced articles associated with this model, click here.

 

Presentations History:

Tim Dreby has been running professional survivor-led psychosis focus groups for the past twelve years in a public Intensive Outpatient Program at Highland Hospital in Oakland CA. He has a Masters of Education from Temple University obtained in 1998 and a MFT License obtained in 2008. He also survived a mid-career “schizophrenia” diagnosis that involved a three-month hospitalization in Montana State Hospital and a two-year emergency state about which he wrote an award-winning memoir.

In 2013, Tim Dreby authored an Alameda County Innovations Grant and started to make public presentations with a small band of people with lived experience. Since the close of this program he has been presenting and developing this material in local venues and through collaborations with the Bay Area Hearing Voices Network. This has involved annual presentations at the California Association of Social Rehabilitation Conference, ISPS and other local venues. He has provided this training for six hours of CEU Credit for Solano County.

 

Presentation Outline:

Module One: Introduction

 

1.1 Welcome to the program

• Why are we here: poor outcomes of treatment
• Why is it important: care courts and the road to mass incarceration
• What will I cover: eight part definition of “psychosis” coupled by eight solution constructs
• What’s my story
• The story of the special messages group
• My promise

1.2 Capitalizing on a New Trend in Counseling Psychology

• What the Problem-Specific Trend Does for Therapists
• Problem-Specific Trends and Use of Jargon
• Characteristics of the Problem-Specific Trend
• What the Problem Specific Trend Can do for “Psychosis”

1.3 The Medical Model Definition

• Hallucinations and limited or unhelpful interventions that results
• Delusions and limited or unhelpful interventions that result
• Disorganization and limited or unhelpful interventions that result
• Negative Symptoms and the limited unhelpful suggestions that result

1.4 Mainstream Treatment of Suppression and Stereotypes

• Suppression is the Goal and Deviance is the Mentality
• What a 5150 means in Oakland, CA
• Power of a Word or Stereotype
  • Textbook Definition of Schizophrenia
  • Anosognosia
• Negative Consequences of Suppression

1.5 Treating Psychosis Across Diagnostic Divides

• DSM V Labels
• Divisions in Mad Culture and Where They Come From
• Negative Effects of Differentiation
• Acknowledging Commonalities with others
• What Listening to the Experiences of Others Can Do
• Perspective Helps Us See How We Are Stuck

1.6 Viewing psychosis as a culture instead of a label

• Need for a Mindset of Cultural Humility
• Reasons Consensus Reality leads to Cultural Oppression of Message Receivers
• How Cultural Humility towards “Psychosis” may be Received in Clinical Environments
• Other Examples of Cultural Oppression that Afflict People

1.7 Emerging Neurobiology and Treatment Against Neo-Kraeplinian Views

• What Neurobiology Says
• Neuroscience and the Simultaneous Development of our Understanding of Trauma
• The Hearing Voices Network

1.8 Overview of the Jargon

• Goonie Goo-Goo Jive-Eight Part Definition
• Eight Solution Constructs
• Corresponding HVN Terms
• Reinforcing the HVN Movement
• Problems and Solutions in Red and Blue
• Haphazard Order Makes a Narrative

 

Module Two: Joining

2.1  Special Messages

• Thirteen Examples of Special Messages
• Exploring Special Message Experiences
• Everyone has a Message Profile
  •  Worksheet
•  Notes on the Message Profile
• Special Messages Are More Common Than “They” Lead You To Believe
• More Functional Terms
• Listening for Special Messages to Lessen Energetic Despair

2.2 Sleuthing

• Visual Aids that Help Define Sleuthing
• The Importance of Message Memory
• Related Concepts that Help Describe
• Is it Wrong to Sleuth?
• What Meaning do you Get?
• We Just Sleuthed Together!
• Sleuth with the Message Receiver
• Clyde Dee’s Day-in-the-Life Story
• Sleuthing-To-Do-List
• Sleuthing-Not-To-Do-List
• Later Solutions will Help us Sleuth
• Exercise Demonstration, Sleuthing with Clyde Dee

2.3 Recovery and Reality Tasks

• R+R Tasks During Crisis (pic)
• R+R Tasks in Recovery (pic)
• Support My R+R Tasks!
• R+R Tasks-To-Do-List
• R+R Tasks-Not-To-Do-List
• Toward Social Rehabilitation
• Exercise: Five Minute Day-In-The Life Story
• Questions About the Story

2.4 Divergent Views

• Consequences to Disbelief
• Validation is Crucial
• Avoiding Re-traumatization
• Build Trust
• Navigating Divergent Views
• Validate, Normalize
• Encourage, Disclose
• Quid-Pro-Quo
• Example #1, Clyde Dee
• Divergent View-To-Do-List
• Divergent View-Not-To-Do-List
• Delving Deeper, Instead of Disagreeing
• Informing and Normalizing
  •  YouTube Conspiracy Theory Example, MKUltra
  • Harvard Experiments
  • Sydney Gottieb and Timothy Leary
  • Who is Whitey Bulger
  • MKUltra and Me
  • Discussion
  • Indulging in Conspiracy
  • Studying Whitey Bulger
  • Whitey Bulger Conspiracy YouTube
• Discussion (2)
• Broadening Your Perspective on (for example) Aliens
• Rationale for Indulging in Conspiracy in Group
• Effects of Studying Divergent Views
• Reflections
• Exercise of Identifying YouTube Conspiracy Theories for Heather
• More Divergent Systems will be Reviewed Under Mad Diversity Section
• Know Your Divergent Views

2.5 Message Mindfulness

• What Do You See? A Fish?
• Staying Present in the Moment
• Detaching from the Experiences
• What this Concept Does
• Past Experiences Are Important
• 3 Part Message Mindfulness Process
  • Whittling it Down to the Experience
• Fourteen Examples of Special Messages
• Message Mindfulness and Clyde Dee
• Mindfulness Tasks

 

Module Three: Flexing

3.1 Theory/Frameworks

• What is the Deeper Meaning? (of a Fish)
• The Difference Between a Theory and a Framework
• Studying Theory/Frameworks is Healthy
• Theories/Frameworks To-Do-List
• Theories/Frameworks Not-To-Do-List
•  Visual Aid
•  Message Crisis (visual aid)

3.2 Mad Diversity

• Diverse frameworks get revealed in group
• Framework Examples (1)(2)(3) Obtained at Highland
• Political Causation
  • Group Activity Create a list of secret societies that target message receivers
•  Spiritual Causation
  • Spiritual Emergence Narrative
  • Spiritual Conspiracy Video (1)(2)
• Trauma Causation
  • Compassion for Voices Video
  • Jacqui Dillon Quote
  • Personal Stories that Triggered Episodes
•  Psychological Causation
  • Psychological that Veer Towards Trauma Explanation
  • Discussion
•  Scientific Causation
  • Mainstream Generalizations
  • Creative Scientific Explanations
• Artistic Causation
  • Art that code resistance to slavery
•  Reflections
•  Diversifying Frameworks Help Us Remember the Limits of Our Ability to Understand

3.3 Functional Flexible theories

• Tool that Can Help Therapist Creatively Sleuth with Message Receiver
• Suspension of the Concept of Reality
•  Create a Potentially False Reality to Ease Torment
• Humor and Irony Help
• Visual Aid
• With Mindfulness and Functional Flexible Theory/Framework Rope Strands Flap in the Wind
•  Consider This Workflow
•  Lighten the Gravity of the Trauma
• Functional Flexible Framework To-Do-List
• Functional Flexible Framework Not-To-Do-List
• Reality Testing Without Consensus Reality
• Facilitator’s Demonstration
• Remember the Workflow

3.4 Trickster Messages

• Carl Jung and Wikipedia
• Negative Tricksters: Definition
• Negative Tricksters: Examples
• Labels and Stereotypes Lead to a Diagnosis Becoming a Destiny
• Most Survivors Have Lived as Stereotypes at Some Point
• Positive Tricksters: Definition
• Positive Tricksters: Examples
• Tricksters Make Us Act in Ways that Are Inconsistent with Our Goals
• Managing Tricksters is Like Changing Your Relationship with a Voice
• Changing Tricksters by Helping Them Out
• Tricksters To-Do-List (1)(2)
• Tricksters Not-To-Do-List (1)(2)
• Discussion
• Using Tricksters Demonstration #1
• Tricksters, Not Reality-Checks (1)(2)
•  Good Reality-Checks
• A Reality-Check Gone Wrong

3.5 Positive Spiritual Energy Solution

•  Applied to Negative Tricksters
• Applied to Positive Tricksters
• Visual Aid
• Sleuthing Pics (Review)
• When All Messages May be Tricksters
• Setting Mantra/Prayer of What they Want
• This Mantra/Prayer Becomes Their Agency
• Demonstration with a Negative Trickster
• Demonstration with a Positive Trickster
• Discussion (1)(2)

 

Module Four: Behaving

4.1 Retaliation Reactions

• Retaliation Reaction Examples
• Complicated and Traumatizing Stories
• Rationale for Telling Our Stories Associated with Our Reactions
• How to Excavate the Story
• Retaliation Reactions Demonstration #1
• Examples of Questions Needed
• Retaliation Reaction Demonstration #2
• Prepare Questions to Uncover Messages
• Retaliation Reactions To-Do-List
• Retaliation Reaction Not To-Do-List
• Visual Aid

4.2 Social Sanctions

• Social Sanctions Become Complicated Stories
  • In the Hospital
  • In the Deli
• What Social Sanctions Occurred?
• Discussion Questions
• Social Sanctions To-Do-List
• Social Sanctions Not-To-Do-List
• Visual Aid
• Unhealthy Learning from Social Sanctions
• Enhancing Motivation for Social Rehabilitation
• Learning When to Conceal this Information
• Unhealthy Learned Behaviors
  • Need for Safe Sanctuaries
  • Group and Individual need to be a Safe Place
•  Learning to Get Away from Social Sanction
• Visual Aid
• Social Relationships in which Social Sanctions can be Undermined
• Safe Spaces are Immediately Needed
• Avoiding Political Acts of Punishment

4.3 Learning Limits and Nine Social Sanctions

• The Need to Understand a Person’s Limits
• Learning Limits
• Challenges to Learning Limits
• Using Social Rehab to Teach Natural Limits
• Starting with Behavioral Change
• Differing Skills Needed for Work
• Learned Behaviors from Institutions (Review)
• Barriers to Social Rehabilitation
• IPS Model
• Breaking through the Barriers
• Why to I say “Nine” Social Skills
• Nine Social Skills (1)(2)(3)
• Learning to Trust Others Takes Time
• Exercise

 

Module Five: Thinking

5.1 Stigma

• Social Stigma
• Institutional Stigma
• Self-Stigma
• Not Limited to Mental Health
• Discussion
• Stigma Explains What’s Been Happening
• Patrick Corrigan Studies

5.2 Anti-Stigma Cognitions

• Potential Shortcomings of Cognitive Therapy
• Cognitive Behavioral Therapy
• Cognitive Distortions and Institutional Assumptions
• Distorted Thinking Chart (1)(2)(3)
• Irrational Treatment is Common in Warehousing Environments
• The Irony of Then Being Taught About Distorted Thinking
• Stigma Demonstrations (1)(2)
• Conducting a Rational Inventory
  • Activating Event (Reviewing Initial Interests, Passions and Inclinations)
  • Beliefs (Learning About the Stigma)
  • Consequences: (The Internalization of the Stigma)
  • Disputing the Belief (Positive Affirmation List)
• What is it like for Participant to Complete a Rational Inventory
• Additional Ways to Dispute Stigma
• Additional Considerations

5.3 Weller Than Well

• The Reframing Process
• The Limits of Rational Thinking
• Different Realities
• What if Both Realities Worked Together?
• A Message Receiver’s “Wise Mind” is Their True Reality
• When Both Realities Work Together the More Truth and Beauty and Knowledge
• My Journey in Consensus Reality
  • Four Stories About Specific Messages
• Rationality As a Tool
• Discernment of Intuitive Knowledge

 

Module 6: Summary

6.1 Integration of our Learning into Group Practice

•  Structuring and Running Groups
•  Devising Questions
• Starting Off the Group
•  Creating Optimal Group Conditions
  • Focus On Uncovering Stories
  • Find a Way to Participate
  • Be Prepared When the Group Gets Stuck . . .
•  HVN Values an Ethics (1)(2)(3)(4)(5)
• Power-Sharing Ethics to Help Avoid Expertise
  • Let the Group Explore
  • Don’t Be Over-Directive
  • Allow Time for Socialization
  • Maintain Attitude of Learning
•  Managing Disruptive Behavior
• In Constructing an Agreement
•  If the Contract Fails
• What Is Your Response to Excluding Group Members from Treatment

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