Reclaiming Our Story
Reclaiming Our Story
Doug Westberg
Peer Residential Treatment Specialist
Kellogg Creek RTH
We appreciate how adverse childhood experiences, trauma, and institutionalization can create, mimic, or exacerbate mental health conditions. This provides the context for our treatment: we work to reduce the impact of adverse experiences on those we serve.
ColumbiaCare Services Inc. Treatment Philosophy
I’m proud of the fact that ColumbiaCare decided they needed to hire full-time peer support specialists, and hired me, with 60-plus years of lived experience and a Bachelor’s in Sacred Music. So it is with deep circumspection that I offer the following case study:
“Sage” is a woman in her 40s who presents as much younger with her diminutive stature, pageboy bottle-blond hair, and absolute refusal to tolerate being dismissed. She has lived through intolerable trauma from an early age. In a stable situation now, she constantly looks for ways to be helpful to the household and to her fellow residents. Frequently, she is experienced as “coming on too strong,” “overstepping her bounds,” and her helpfulness is patronized as a “coping mechanism.”
When Sage snaps at a staff member who is being dismissive, perhaps saying something like “That’s our job, you let us handle it!” she will generally make her case matter-of-factly, if heatedly, then “storm” out of the house and calm down.
The temptation for us to react to Sage as though she were a rebellious teenager “acting out” can be difficult to resist. What I see now is a woman who has a chance for the first time in her life to define herself and her boundaries, who is showing a remarkable ability—and willingness—to manage her labile emotions while fiercely hanging onto her personal integrity. She controls her language, disengages from the confrontation, leaves the milieu, and self-regulates. There have been many times when I wished I’d had that kind of self-control.
In a powerful paper entitled “Peer Support as a Socio-Political Response to Trauma and Abuse,” Shery Mead, who literally wrote the book on Intentional Peer Support, paints a heartbreaking picture of trauma victims who are encased in the narrative dictated by their abusers (“you brought it on yourself”), and then have to endure being encased in the narrative dictated by the mental health system. Even when the trauma is acknowledged, they are classified as mentally ill, and saddled with labels like PTSD and Borderline Personality Disorder. They are judged as “non-compliant” for resisting boiler-plate pharmacological treatment, or derided as “frequent flyers” when they seek help too often. Says Mead:
We either seek treatment or we are forced into it. If we are lucky (and economically privileged), we may find treatment that supports us to find and rebuild our voice, and helps us to move away from seeing ourselves as “the problem.” If we are not so lucky, our actions (or other’s assessment of our actions) may lead us to further abuse in terms of forced treatment, locked doors, physical restraints, and debilitating medications. Either way, we are labeled with a psychiatric diagnosis and our experience is further embedded in the “self as problem,” and our pain as a symptom to be treated. We again learn to view ourselves and our experiences through others’ eyes rather than through our own. (emphasis mine.)
In this context, then, how do we “work to reduce the impact of adverse experiences on those we serve?” Giving clients access to peer support from someone who can validate their feelings, who can empathize from personal experience, who can show them a person who has survived the same sort of trauma and doesn’t have to be defined by it anymore, who can say with absolute authenticity, “You are not alone,” becomes not just a nice thing, but indispensable.
But, clearly, it’s not enough to have a peer support specialist visit the house once a week if the regular non-peer staff treats you, however subtly or unintentionally, in a way that reinforces or reminds you of your otherness. When you’ve spent your life thinking of yourself as the problem, the very last thing you need is to be treated like a problem child.
The principles of person-centered therapy, that have been around since Carl Rogers asserted them in 1957, pervade ColumbiaCare’s Core Competencies, and offer a simple if daunting roadmap:
Congruence (be authentic, be who you are, don’t hide behind a façade or a badge of authority.)
Empathize with understanding (you don’t have to be a peer. Hint: start by listening.)
Treat clients with unconditional positive regard (and don’t let your own values get in the way.)
As Dr. Stephen Joseph explains in an excellent PsychologyToday.com blog article, all three of these components must be present together to be effective. Without unconditional positive regard, without vulnerability, empathy is at best only sympathy. Without empathy, unconditional positive regard rings hollow.
I’m an amateur. There isn’t a day goes by that I don’t feel I’m making it up as I go along. Yet what I can do is enter into authentic relationship with my residents, identify with them, and treat them with utter respect. It’s all I have. As it turns out, it goes an awfully long way. You can do the same thing.
References:
Peer Support as a Socio-Political Response to Trauma and Abuse (2017) article by Shery Mead, MSW. This link can also be found at https://www.intentionalpeersupport.org/articles/
Joseph, Stephen, Ph.D.: Blog article: “3 Therapist Attitudes That Are Key For Healing,” April 22, 2021. https://www.psychologytoday.com/us/blog/what-doesnt-kill-us/202104/3-therapist-attitudes-are-key-healing Retrieved 6/1/2021.
Further Reading:
Mead, Shery, MSW: Intentional Peer Support: An Alternative Approach (West Chesterfield NH: Intentional Peer Support, 2015)
Article: “Connecting with Clients” by Laurie Meyers. In Counseling Today 8/18/2014, https://ct.counseling.org/2014/08/connecting-with-clients/