The Benefits and Importance of Empowerment

"The focus on empowerment of people with severe mental illness is important and warranted for both practical and philosophical reasons.

From a practical perspective, the empowerment of people with mental illness through meaningful participation in decision making benefits both them and the organizations that provide services to them.

• People with mental illness who meaningfully participate in treatment planning, for instance, are more likely to meet their treatment goals and be satisfied with their services.
• Similarly, people with mental illness who select their residences and have control over major residential decisions are more satisfied with their housing and function more independently within it. 
• Likewise, mental health agencies that promote client participation in organizational decision making are more likely to develop service programs that are responsive to clients' needs.  
• A focus on empowerment also is important because participation can be viewed as a right.  Simply put, people should have a right to participate in decisions and activities that will affect their lives."  

 From Empowering People with Severe Mental Illness by D. Linhorst, Oxford University Press (2006)

This passage refers to empowering people with severe mental illness and yet the values espoused may pertain to any previously or currently oppressed group - including mental health professionals who are women and/or persons of color.

To what extent do you participate in the decisions and activities that will affect your life?

This is the political process.  This is what is meant by, the personal is political.

Empowered vs. Controlled

"Judi Chamberlin (1978) wrote about her experiences while in a psychiatric hospital in the 1960s:

The whole experience of mental hospitalization promotes weakness and dependency.  Not only are the lives of patients controlled, but patients are constantly told that such control is for their own good, which they are unable to see because of their mental illness.  Patients become unable to trust their own judgment, become indecisive, overly submissive to authority, frightened of the outside world . . . The experience [of hospitalization] totally demoralized me.  I had never thought of myself as a particularly strong person, but after hospitalization, I was convinced of my own worthlessness.  I had been told that I could not exist outside of an institution.  I was terrified that people would find out that I was an ex-patient and look down on me as much as I looked down on myself. (pp. 6-7)"

From Empowering People with Severe Mental Illness by D. Linhorst, Oxford University Press (2006)

A woman with mental illness writes about her experiences in a psychiatric hospital in the 1960s and yet the reaction provoked by this experience sounds like the same reaction of many non-hospitalized students and professionals today - second-guessing self-perceptions, profoundly doubting intuition, ambivalent about what to do, afraid to rock the boat, afraid of our own voice and desires.  The conditions of oppression, regardless of context, setting, or target, can provoke similar reactions.  We can choose a different reaction.

We can  . . .

• trust our own judgment
• decide what is best for us (despite social pressures)
• have a balanced relationship with authority
• face the world with confidence and respectful humility

Soul Migration

Abstract:

Just as the human being comes apart at death, with the body dying and decaying while “the breath of life” persists, we suggest that a person comes apart in a similar way at other crucial junctures of life, such as moments of excruciating shame and delirious orgasmic experience, insurmountable trauma and ecstatic spiritual experience.

The abused child, like shipwreck survivors in an overcrowded lifeboat, must sacrifice some aspects of the self in order to preserve others. The more overwhelming the assault, the more essential and closer to the core is that aspect that must be sacrificed. Inner resources such as innocence, trust, spontaneity, courage, and self-esteem were lost, stolen, or abandoned in those early traumatic moments, leaving an immense empty space. The psychic energy cast off through dissociation and splitting, the sacrificed aspects of self, do not simply disappear into thin air, but rather continues in split off form as a primitively organized alternative self.

Retrieving these inner resources in age regression to those traumatic events reunites the sacrificial alternative self with the immanent embodied person, strengthening the fabric of the soul’s energetic field.

What we are proposing here is a profound level of splitting in that what is split is neither consciousness nor ego nor self, but rather one’s essential spiritual identity, what we are calling one’s soul. A further distinction is drawn in relation to the concept of where that separate aspect of oneself is kept; that is, it is neither repressed into unconsciousness (vertical split), nor allowed to alternately come into conscious awareness (horizontal split).

It is sent into hiding from itself, in the “witness protection program” for the soul. Strength of character, resilience, determination, deep trust all come from repair of disruption in intimate relationship, not through eliminating any disruption. Likewise, the growth of the human being spiritually is achieved through the repair of the bond with his/her soul following disconnection (miscoordination).

Soul Migrations: Traumatic and Spiritual
David Hartman, MSW and Diane Zimberoff, M.A.
Journal of Heart-Centered Therapies, 2006, Vol. 9, No. 1, pp. 3-96

Scientific Progress & Human Relationships

A friend of mine recently noted that I write about my mentors and that I seem to have many.

I know what I know and I know what I don't know.  And I am not ashamed about what I don't know.  When I am stuck, I think to myself, "who can help me now?"  Then I reach out.  It surprises me and restores my faith in humanity every time an expert responds.  That is how I collect mentors.

I am finding that brilliant folks are really accessible, down-to-earth and willing to share their God-given talents and hard-won lessons learned.  So grateful for that.

When I mention I am meeting with one mentor, another mentor will note, "Wow, he's a serious scholar" and I will think, "Yikes, I should have known that" or "Yikes, I am glad I didn't know that before I asked all those silly questions."  But the truth is, I would have asked anyway, because that is how I learn.  And fortunately, no matter how brilliant the mentor, I have always been treated with respect.

Thomas Kuhn wrote about the process of scientific revolution - how we go from one set of accepted truths to a new set of accepted truths.  It is highly influenced by a political process. Privileged "normal science" shifts when sufficiently challenged and no longer socially accepted.

Scientific discovery and progress is highly influenced by a network of human relationships.  In the same way that artistic or literary circles influence each other, so do multi-disciplinary scholars.  Imagination inspires me but it is in the context of human relationships and mentoring that my ideas become tangible manuscripts and studies.

"We can only evolve in a cooperative society.  Cooperation and need for contact are built in.  There is no genetic basis for individualism.  Individuals die and cooperative groups evolve and survive."


Collectively, we push things forward.  Finding your wolf pack is essential.  Thanks for lunch, Maria, and inspiring this post.

More on Resilience

"Resilience is a concept that originated in physics. Once transplanted into the field of developmental science and social behavioral research a generation ago, it inspired the investigation of key protective factors, opportunities, and experiences that enable young people to resist stress and even thrive in the face of adversity. Increasingly, it is the basis for programs, policies, and public health practice that seeks to employ the dual strategy of reducing risk while enhancing protective factors that place (or keep) young people in a healthy developmental pathway.

"Resilience Defined
The word resilience comes from the Latin resilientia meaning the ‘action of rebounding.’ The Oxford English Dictionary defines resilience as ‘The action or an act of rebounding or springing back.’ The field of physics first adopted the term resilience to describe the capacity of materials to retrieve their initial shape following exposure to external pressure (i.e., flexibility and elasticity). More broadly, resilience represents the capacity of dynamic systems to withstand or recover from significant disturbances. Therefore, scientists can examine resilience at many levels, over varying time frames, and from different disciplinary perspectives. Some scientists might use terms like equilibrium or homeostasis when they are considering this process of ‘righting oneself,’ either as a system or as an individual. In developmental science, resilience refers to positive adaptation in the context of significant threats to development (i.e., adversity). Most developmental research focuses on resilience within individuals, although researchers also apply the concept to systems within which individual and collective development occurs such as families, classrooms, schools, or communities. In short, the term is widely applicable, well beyond its traditional, specific use in describing the ability of materials to resist stress or insult, or the capacity of objects to resume their form or function following challenging or demanding circumstances."

Resilience by Resnick, 2007

Study about Beliefs: Parents & Young People on Effective Interventions

"One surprising finding was that young people (particularly young adults) were more likely to see close family as a source of help than were parents, suggesting that parents may be underestimating their own potential role."

"Ideally, the public endorsement of recommended interventions should be close to 100%. The biggest gap is for psychiatric medications, where <50% rated recommended interventions as likely to be helpful."

"Psychological therapies, such as cognitive behaviour therapy, are recommended for all the disorders covered in the survey. Cognitive behaviour therapy was rated as likely to be helpful by less than half of adolescents, young adults and parents, and this held irrespective of the vignette presented. However, this low rating was largely because of ignorance of this treatment (which may be related to its limited availability). Unlike medication, respondents did not often see it as harmful. By contrast, the non-specific psychological intervention of counselling was overwhelmingly rated as likely to be helpful by all groups for all vignettes."

"Previous surveys of adults have shown relatively positive views of complementary and self-help therapies. In the present survey we asked about a range of interventions not covered in the earlier surveys. The complementary and self-help therapies included were those known to have some evidence for effectiveness in treating depression or anxiety disorders in adults, although the amount of evidence on these therapies with adolescents is much poorer, making comparison with young people’s preferences more difficult. Many of these therapies were frequently rated as likely to be helpful (physical activity, relaxation training, meditation, massages, morning light exposure, self-help books). St John’s wort did not rate so highly, but this appeared to be largely due to ignorance of what it was rather than a concern about possible harms."

"These findings have implications for areas on which campaigns to improve mental health literacy need to focus in the future. The first is in attitudes towards medication. Although there is evidence that attitudes of adults in Australia have become more favourable in recent years, there is still a considerable gap with clinical practice guidelines. The second is with the preference for generic psychological interventions (counselling) compared to specific interventions known to be effective (e.g. cognitive behaviour therapy). A similar gap exists with the professions providing psychological therapies (psychologists and psychiatrists vs counsellors). There is evidence that knowledge and attitudes of young people and adults can be changed by community campaigns so these are feasible goals. Recent changes in funding provided under Australia’s national health insurance scheme, Medicare, have made psychological services more readily available, but young people need to know about the availability and usefulness of these services."

"Another possible approach to improving evidence based care for young people would be to use terms to describe services that would make them more appealing to this age group and their parents. For example, services might be more acceptable if psychological therapies were labeled as ‘counselling’ and mental health professionals as ‘counsellors’. To some extent, this approach runs counter to the aim of improving mental health literacy and requires cautious exploration."

"The present results highlight the need for further evidence on complementary and self-help interventions. We face a situation in which some therapies that have a strong evidence base are perceived less favourably than others that have weaker supporting evidence. As well as trying to improve the mental health literacy of the public about what is known to work, we need to do further evaluation of interventions that already have wide acceptance and use. Interestingly, a recent study found that people who had experienced depression also rate many of these types of interventions as having helped them."

"Because of their more limited life experience, adolescents require assistance from others in their social network to seek appropriate professional help. In this regard, both family and close friends are viewed favourably as sources of help. However, parents tended to underrate their importance compared to their children. Parents need to be a target for first aid knowledge and skills to assist young people who develop mental disorders. Although it is perhaps too much to expect young people to provide a high level of peer support, there is certainly room for some basic skills. For example, adolescents often do not respond to a friend in a way that could facilitate appropriate help, such as engaging a parent, teacher or school counsellor to help. Even with a suicidal peer, many young people would not tell an adult."

"In conclusion, this is the first national survey of young people’s treatment beliefs in any country. As in previous surveys of adults, it found some gaps between public perceptions and current clinical practice. These gaps can be the target of community mental health literacy campaigns and training of key supporters in first aid skills. However, consideration can also be given to describing some interventions using terminology that may make them more acceptable to young people. Furthermore, the evidence base needs to be extended to more fully evaluate those complementary and self-help interventions that are already widely accepted by young people."

TITLE: Young people's beliefs about preventive strategies for mental disorders: findings from two Australian national surveys of youth
AUTHOR: Yap, Marie Bee Hui; Reavley, Nicola; Jorm, Anthony Francis
AFFILIATION: Orygen Youth Health Research Centre, Centre for Youth Mental Health,
University of Melbourne, Parkville VIC, Australia
SOURCE: Journal of Affective Disorders, 2007 Published online 3 October 2011

We need more family therapy training in graduate school. The evidence demands this!