Psychiatric peer movement and the trauma movement...

[Rene Andersen]

Hello brothers and sisters on healing journeys,

Even as I write the discussion title I smile inwardly. For me, as for many others, there is no difference between the two - trauma and peer movement(s). They are integrated in me. To continue with this artificial distinction is to buy into the silo-style of care that is the way of health and human services.

Over 25 years ago, I asked one of the leaders of the psych movement if I "qualified" as a c/s/x. He told me that unless I had been committed and had involuntarily received a shot of thorazine, I could not identfy as a psych survivor. Although I could imagine the horror of being imprisoned, medicated into senility and having "no way out" but to comply; here was, a group with which I shared the feelings of hopelessness and terror, yet I did not have the specific experiences he outlined. This was a particularly difficult rejection since I truly believed I belonged; I had a list of diagnoses that had put others in institutions, I heard voices and had hallucinations, I'd been medicated as a means of restraint, experienced physical and sexual abuse, and the worst, I had been held down and betrayed....

Ray Unziker, a mother of the survivor movement, kept telling me to identify, "come out" as a crazy woman. I told what this fellow had told me and she said that indeed the experiences he had mentioned were pivotal, yet that alone did not mean that I was not a member of the psych survivor movement. But I had found my niche... talking with other survivors of abuse/violence. We had what has been termed "multiple vulnerbilities" - hospitalization, addiction, homelessnesses, psych diagnoses, violence in our lives. The violence being the central feature of a hellish life.

I identify primarily as a survivor of abuse. I believe that that abuse has led to many other situations and conditions (addiction, diabetes, obseity, madness) in my life. I believe that healing from the abuse has been instrumental in my "wellness". The healing is the source of my passion, strength, and the wellspring of my transformation.

There are the 10 principles of recovery developed by Dan Fisher et al that include: choice, empowering relationships, and valued roles. These are the principles that guide recovery - from addiction, madness, and violence. These are not separate from the trauma-work but central to it.

Let us not follow in the footsteps of the "systems of care" that continue to fragment our lives and divide the movement, rather let us join together to return to our communitites, loved ones, and above all, our own true selves.

In peace,
Rene

[Lyn Legere]

Hi Rene,

This artificial distinction reminds me a lot of the earlier days of AA when only those that had "hit bottom" hard enough were allowed in. It wasn't until the movement felt secure enough that it could move beyond that to see that it was really the emotional toll of alcoholism rather than the outside losses that was the common ground of shared suffering and healing.

I would hope that, by now, the psychiatric survivors movement would feel secure enough to not hold onto these same types of artificial measurements. Ironically, the very things that supposedly create the difference - coercive practices, force, lack of choice, being imprisoned, etc., replicate the experiences of many abuse survivors. The only difference is that for the psychiatric survivors it is the system and for abuse survivors, it is usually those that were supposed to love and protect them, adding to the depth of betrayal.

In the end, the commonalities are far stronger than any difference, and as you so eloquently described, they are those feelings of loss, betrayal, hopelessness and utter alone-ness. When we strip away the events and look to the soul pain, I think we'll see that we all are walking the same path.

[Robert C. Grupe, Ph.D.]

Hi Rene and Lyn..

I am new to this forum. Let me focus in on what may be a deep underlying element in need of change in the system. I frame my response actually on years of teaching organizational change at university (OSU) and directly in corporations. There is a mental compulsion, indeed I would go so far as to call it an addiction, within administrative levels of many organizations: It is a compulsion to control "FOR OUR OWN GOOD" Within the health care field it can many times be "justified" by the years of specialized training which brings many a practitioner to their level of influence along with an attitude that they have the educated power to create recovery through a certain template. Those templates at times, as Lyn had shared,"replicate the experiences of many abuse survivors". I cannot tell you how many times in corporate business environment when I have counseled
employees traumatized by coercive directive-driven administration decisions which do not allow the employee to utilize their creativity in doing the work that needs to be done for the company. Those principles developed by Dan Fisher including choice, empowered relationships and valued roles are stripped away from many employees in directive driven environments - leaving their emotions numb, raw and bleeding.

There is, in my opinion, a deep infection in our cultural system which , through systems of care, says silently in a powerful whisper: "We have been educated to help you. We will fix you. Sit down, listen and do what we say." It is a directive-driven approach which dates back to the beginning of the industrial revolution.

There is another approach as you both know, which is immensely powerful. And that is allowing the healing which exists in each consumer to begin to grow, as does the power in a seed, not by directive ( can you imagine a farmer jumping up and down on the field demanding that the plants grow faster!) but by helping to provide the nurturing, emotional peer connection and other tools of mental health practice as they are appropriate to bring a holistic healing.

As a person in long term sustained recovery from both mental health issues and substance abuse, I have found that my recovery has come through the HOPE given me through those who have already swam the channel and
led me to truly believe that the power to transform lies deep within me. As it does for each of us. I am honored to be a Peer Recovery Support Specialist credentialed through ODMHSAS. When I communicate with those who are in the process of transformation, my first comment is a statement and a promise " I am here to be student of you." We'll take this journey together.

[Rene Andersen]

Robert and Lyn,
Thanks for your thoughtful responses. My experience is that it is primarily folks in addiction recovery who struggle the most with identifying fully with both "conditions" - mental health labelling and addiction recovery. They also seem more closed to considering the centrality of trauma in their lives.

This could be that AA and other 12-step programs offer a "home", a group, a "fellowship" that provides the lonely soul with companionsionship, identlty, and activities to fill the, the often, empty space in between morning and evening. To be asked to re-consider this life-saving sense of purpose to one's life - an addict/alcoholic in recovery - is threatening. So threatening that in our local peer recovery center there is a tremendous (but slowly diminishing) resistance to sharing the space for a day a week with people who primarily identify as consumer/survivors/ex-patients. The very people who have been the most resistant are on psychiatric meds which they minimize or do not speak publicly (about) since it is often not accepted in traditional AA circles.

Perhaps, another reason for the recovering addict/alcoholics lack of willingness to identify with the pschychiatric survivor movement is the stigma of madness is greater than the stigma of addiction.

Substance abuse recovery programs (AA included), like mental health systems, tend to narrow and focus people's experiences to the "presenting problem". Although, addiction recovery programs might be a bit ahead of mental health programs as some address issues such as parenting.

My own experience with 12-step recovery is that the first year was a gift but as the second year began, the memories arose in waves. All that I had worked so hard to keep at bay, kept bursting through the cracks of denial. After a time, my therapist suggested hospitalization, AA said pray harder and go to more meetings (alreay attending 7-9/week!). Now, 22 laters I am not surprised when I hear about people "going out", drinking/drugging or hospitalized for psych reasons. The long-denied, forgotten or minimized abuse memories merge; threatening sobriety. And still addicts/drunks focus on SA recovery exclusive of recognizing the impact of violence/trauma in our lives.

And so to close the loop on this response, it is understandable how people in addiction recovery have a lot more to lose in the joining of these two movements than those in recovery from psych diagonses. They are threatened with losing membership in the addiction recovery "club " which provides opportunities for connection and which has given life meaning, they are thtreatened with the dark underbelly of addiction recovery, and threatened with the spectre of the mental health diagonses and the accompanying stigma.

Rene

[Robert C. Grupe, Ph.D.]

Once again, in a way it comes back to silos. AA has helped a multitude to transform their lives.
My journey through alcoholism recovery did not take me through the AA model.In 1984 I went through
Neuro-linguistic Programming treatment. Which worked, because I was ready for it to work. But before discovering alcohol I came close to damaging my heart with excessive exercising at age 14 to ease the pain of internal anger. Then I moved to joining a legalistic cult seeking peace in my soul without engaging in a true spiritual journey. I began using a religious template as a drug of choice. When that bandaid no longer filled the black hole inside of me, I moved to alcohol which took me to death's door. After my recovery from alcoholism, still not facing the mental health issues that ate at me, I discovered food and that was my last addition.
You can read about my journey through mental health and addiction challenges in my autobiography "Building Sandcastles - A Baby Boomers Journey Through Addictions". The book is in PDF file and can be downloaded free through my website www.drgrupe.com. As you read the book you will notice the THREAD OF TRAUMA that run through my behavior from early childhood.

Some months ago I was fortunate to attend a trauma-informed Training featuring the book by
Lisa M. Najavits SEEKING SAFETY which explores the link between Trauma and Substance Abuse.
The bottom line that I am seeing is that a majority of those who self medicate (in whatever form that takes- food, depressive religious obsession, exercise or substance abuse) are seeking escape from emotional trauma. I am becoming more and more excited about the co-occurring approach to treatment. Now, in Oklahoma City we have a substance abuse advocacy agency (www.ocarta.org) and a mental health Alliance (www.ok.nami.org) that co-sponsors a radio program "Pathways to Recovery" aired each Tuesday from 9-10:30AM (CST) and is streamed worldwide at www.ktlr.com
at that time. I am the Co-host along with Donna Woods Bauer, CADC, Executive Director, Oklahoma Citizen Advocates for Recovery and Treatment Association and Karina Forrest, Executive Director,
National Alliance on Mental Illness-Oklahoma. Each week guests join us to self-disclose their journey through mental health and substance abuse challenges. Also joining us are folks from private and public agencies involved in providing recovery support. Only through a vast army of those in recovery from mental health and substance abuse speaking out can stigma (also known as discrimination) become a thing of the past as it has over a span of time with Cancer (once whispered about as " the Big C!" or type two Diabetes.

[Janice Sorensen]

Hey All,
You know, I have to be honest, as I started reading this I had to go back several times to try to see what it was you were saying, Rene. The reason I did not get it at first was because it just seemed too obvious to me- too obvious that there is a connection between the trauma and the psych survivor. I mean, come on, how does one not get this?

The only way they aren't connected is when they are chapters in a book, bars on a graph, or boxes, taped and stashed.

In real life, in my life, there is no line, no continuum; it is all amuck. I cant even begin to separate it. The sexual abuse, the violence and the psychological manipulation formed fibers that eventually became woven with the substance abuse, confusion, delusions, promiscuity, bulimia, self-inflicted violence, depression and desire to die. My mother's depression, substance abuse, suicide attempts and sexual abuse (at the hand of her psychiatrist as a matter of fact!) were all one fabric as well. They were not separate entities or divided actions, they were a sum of the whole, they were my mom.

And I as well, have been the chicken and the egg and the baby and the bathwater. I didn't know that what was happening in my life was trauma, it was just my life. I didn't suddening and for no reason become "mentally ill," or "blue" as my mom called it. I was in forth grade when I first attempted suicide. I'd had a bad day in Home Ec and this is what you did in my house. My mother'd had three or four (I dont even know how many) suicide attempts by that time in my life. It really seemed like the thing to do. It was what you did when things were really bad. What catagory does all that go in. Is it cake? is it candy? Trauma? Psych?

You know, I've been spending time with a woman who has been hospitalized for over a month. Somehow she got so locked into the system that they were unable to see that it was her hospital stay that was becoming the worst problem in her life. She was so discouraged when I first met with her last week. She hasn't been able to leave the hospital because she didn't have an apartment. Today we went out and found her her dream apartment, shopped for a dress and sat over coffee. It was only a three hour leave from the hospital, but she no longer wants to die, she said it was one of the best days of her life, and that she now has hope. I, swear I am not making this up. It was a fantastic afternoon and at a fraction of the cost of the same time spent in the hospital.

I really feel like people are becoming more and more open to the peer movement. I dont know if it is because they are being nudged and mandated to and to be honest, I dont really care. It is happening. I feel as though I am walking in the wake of so many who have suffered before me and it is my duty to carry the torch with grace while still holding the fire of the injustice deep in the memory of my heart. I think we try to work together with those providers who are either getting it or being directed to give us a try. Dont hear this in its extreme- I am not saying, roll over, but what I am saying is "Do you want to be right or do you want to be effective?"

I wear my story on my sleeve. I have always been free to say- even to my children when they were way little, "Oh, that was when Mommy was in the drug rehab..." ("Mommy, what's a drug rehab?") Or, "Mommy painted that when she was in the psychiatric hospital." ("Mommy, what's a siziatric hozpidol?") They have always known that I hold no shame. That is where we start, impo. There and being open to educate those who dont yet get it. We end stigma with our compassion and clarity.

I love being part of the peer movement. (But which one?? The trauma movement? The psych/survivor movement? The substance recovery movement?) Like I said, it seems so obvious to me. -j

[Rene Andersen]

Janice,
Thank you for your powerful response I,too, cannot understand the separation of the parts of our lives that create our entire being.
I am saddened by the fact that our sister/brother travelers on this healing journey embrace single identities - psych survivor, trauma survivor, person in addiction recovery - thus reflecting the silos that are the "treament" systems. This work we are doing has the promise of icreating conditions for the an ntegration of our experiences on an individual level.
Yes, it seems obviouos to me too.
R

[Annie]

There is no doubt that being at peace with itself is the cure for most evils, spiritual peace and tranquility are the secret emotional of all evil

women smoking cigars

[Genita Love]

I agree with what you've said. In fact, last fall, when I participated in the KU CAP training program for my CPS Certification, I had a classmate that tried to tell me that there was NO way I could have a mental illness because I wasn't struggling with the material in class. It just so happens that Class room learning is a particular strength I possess. It's in social settings and interacting with my peers is where I have problems!! Like you, I primarily describe myself as a survivor. ( A survivor of years of hellish abuse, homelessness, emotional/mental abuse, a psychiatric diagnosis, and homelessness. Yet, I survived, and still manage to be of assistance to my fellow man- no matter how much trauma I've endured.)
Like you, I've been down trodden and betrayed more than once. However, somehow, someway, God has this amazing way of taking what's bad and making something so good it belies logic and even common sense! Like you, healing from abuse is key to my recovery journey...but, what really turbo boosts it for me is spirituality and a close relationship with God...If not for that, I don't think I would still be on this planet or whatever. - For me that's really the best tool in my recovery tool box!!!