I am in love. I’m in love with this way of working. And I won’t stop. Open Dialogue Washington began in 2018 upon my graduation/commencement from Jaakko Seikkula’s dialogic approaches to couple and family therapy trainer/supervisor training, in collaboration with Dialogic Partners and the University of Jyväskylä.
In 2016, I embarked to partake in the best training course I had ever experienced as a family therapist. The embodiment I experienced working with my Open Dialogue colleagues felt like the missing key in psychiatry and psychotherapy. Something intangible, yet what I knew all along. Something ineffable, yet also a shared language. Something deeply and autonomically human, yet unrepeatable and fleeting. It led me onto a moment-by-moment path where everything I learned in my 27-year long career about systemic family therapy and emergency psychiatric protocols ebbed, and the present moment of love flowed, neither the ebbing knowledge nor the cresting wisdom having any lesser value than the other. The complete work we do in mental health care is this ocean of love.
We are in constant change when we are in crisis. Timelessness sets in. Growth is happening. We don’t exactly know what we need. That is what mental health work is, sitting with this human happening. In the in-between space something happens, and we don’t know what will. This is the paradox. We are navigating the ebb and flow of incoming knowledge we have from research and the ebb and flow in each patient and family’s difficulties (the meanings they make of them.)
“It cannot be taught, but it needs a teacher.”
I’m excited to announce a new series of Mad in America Continuing Education webinars for 2019. They focus on what I believe is a central issue—what does a true informed consent process look like for the prescription of psychiatric drugs? This is a leverage point for changing the paradigm of care by starting with how people are informed about what psychiatric drugs do.
I believe that righting this ship is largely going to be up to non-medical mental health professionals and persons with experience in having been through a system that fails miserably to provide real informed consent. Since we are a continuing education program, our courses are designed primarily for the first group: psychologists, social workers, nurses, licensed professional counselors, and marriage/family therapists. We will continue to apply for continuing education credits (CEs) and at some point recruit more interest from physicians so it would be worthwhile to apply for the more expensive continuing medical education credits (CMEs).Read More
Living in New Mexico means hoping for rain. The state is in drought, with most areas officially in either “extreme” or “exceptional” drought. The soil is full of life waiting for a chance to express itself, but the rare rain forecasts usually promise only “scattered showers nearby,” with the outcome being either clear blue skies or the sight of rain falling elsewhere. New Mexico is also one of the poorest states in the U.S., with more than one in five New Mexicans, and one in four children, living in poverty. We are second in the nation for the prevalence of youth living without connection to work, school, or family. New Mexico ranks high (#7) for people living with serious mental and emotional challenges.
The Fort Collins-based Learning and Self-development Collaborative grant project is midway through supporting its first group of young adults experiencing mood-related distress. It is also actively recruiting for the second group, scheduled to start in late August.
Nearly three-quarters of the young adults in the first group have prior mood disorder diagnoses and have tried psychiatric medications like antidepressants. However, the ineffectiveness and intolerable side effects of the drugs had left them searching for an alternative way forward when they decided to enroll in the Learning and Self-development Collaborative. These young adults are currently medication-free and their outcomes on mood distress, social connectedness, empowerment, and quality of life at six months will be compared to other young adults receiving usual care and daily psychiatric medications in the community.
An initial focus group with participants revealed a number of themes related to young adults’ past experiences with seeking help. Participants discussed feeling frustrated by one-size-fits-all solutions, such as drugs and mindfulness techniques, and invalidated by counselors who failed to connect with their experiences. Lack of information about prescribed drugs was frequently brought up by participants who also shared various stories of “chemical imbalance” and drugs “re-training the brain to relax” told to them by doctors and therapists.
Findings from pre-program focus groups are being used to help inform the content and delivery of educational material in the Learning and Self-development Collaborative.Read More
I have been wondering for some time how we would know if the mental health systems in the United States were really reformed. It is true that there are “a thousand points of light,” many great new and older programs and initiatives out there with tremendous advocacy and efforts at radical change. But when a system leaves so many without recovery-oriented supports, it is like swimming upstream against a powerful current. Here are 25 indicators that if fully implemented would represent a complete system reform.Read More
At the beginning of September, I wrote about the next stage of the Mad in America Continuing Education project—the development of webinar formats and I announced the planning for a “course” on withdrawal from psychiatric medications. At that time, I was able to provide only introductory information but now I can provide a full picture of the 7 webinars that comprise the course and update a few other developments.Read More
I remind myself often how wonderful it is to notice the wealth of resource and intelligence that is all around us. I just left the gym where I watch CNN (while on the treadmill) and I go from the devastation of Puerto Rico to the massacre in Las Vegas and then read an entrepreneurial magazine in the lobby.
Club Business International’s October 2017 publication stated, “When I [the editor of CBI] asked the U.S. Surgeon General Vivek Murphy what was the biggest disease in America today, without hesitation, he answered, ‘It’s not cancer, It’s not heart disease, It’s isolation.’”
One of the results of the incessant technological assault, observes Murphy, “is the pronounced isolation that so many people are experiencing that is the great pathology of our lives today.” The Editors note continues, “International Health, Racquet & Sportsclub Associate Chairperson Derek Gallup counsels, ‘Certainly, continue your search for technological solutions, but, as you do so, remain constantly focused on the all-important human element. In the final analysis, your members, and how they feel about them selves and the team members- those are the critical factors that, ultimately, will determine whether your business grows and thrives… or doesn’t.’”
The Editorial also points out that Thomas L. Friedman, Pulitzer prize-winning author and journalist with The New York Times, states “How ironic, we are the most technologically connected generation in human history- and yet more people feel more isolated than ever. The connections that matter most and that are most in short supply today are the human-to-human ones.”
Personally, I am hopeful. More and more people globally are waking up and re-connecting with our shared humanity and a shared vision of a peaceful and collaborative world. Currently in the U.S. however, a great divide appears to be growing, where we see an acceleration of the breakdown of our social structure and our community infrastructure.
Unsustainable systems are collapsing and something new, hopeful, empowering and global is in the process of emerging. It seems that we need to collectively burn through some darkness before we collectively see the light. Lately, there seems to be a growing isolation and war-like posturing. Let’s shift gears and focus on a hopeful antidote that everyone can apply.
World peace begins with me
Human beings have been making war for a long time in many cultures, meaning in many minds, because the culture is a reflection of the mind.
I am coming to a clearer understanding that when I am not at peace in my own mind, I am waging an internal war and that war is projected onto others whether I am aware of it or not.
The war in my head can be framed around a variety of battles – it can be framed around the ancient and false belief that I am not good enough or smart enough, or if that other person would do something well or if this condition or that condition were met – then all would be worked out and peaceful. I have constructed a story that tints the lens through which I see myself, others, our relationships, and the world.
If I remain unaware of how I have tinted the lens, and I remain stuck in the story, the conditions for peace will not be met. Peace is revealed in the absence of war – in the absence of isolation, separation, judgments, and conditions.
If we take another step deeper, we can see that the source of this war comes from the belief that we are some thing that is separate from others. This early learning, this sense of separation and human disconnection, is so pervasive and integrated into the threads of our culture that it makes it hard to see.
This experience of human disconnection, a separation of self from self and self from others, is a fundamental concept in both trauma-informed practice and in Emotional CPR (eCPR), www.emotional-cpr.org. The impact of trauma and human disconnection played out in my own early childhood, for example, by my experiencing such a profound lack of safety that it resulted in my clinging to anyone who offered safety and anything that could numb the pain.
Another result of the belief that we are some thing and this thing is separate from each other is that we get focused on protecting this thing. Whatever the thing is – our territory, our home, our family – we protect it and hold on to fear, and anger and revenge, and we wait for someone else to do something differently so that we think we can find peace.
Our tinted lens reinforces the idea that that other person is different – separate from me. And this separation perpetuates conflict and war. It perpetuates the war in my head which perpetuates the war I wage with others. The inner war creates global war.
When I am practicing eCPR or human connecting I am cleaning the lens. By that I mean, I intentionally focus on letting go of my own judgments and labels; there is nothing to protect. I focus on perceiving the other person in their full humanity. The distress the person is expressing is a particular patterned way that this person’s internal war has escalated.
As a supporter or listener or fellow human being I focus on being with her and assisting her in finding peace. I do this by seeing the genuine person underneath her lens, underneath the social conditioning, underneath her story. And when I do this, I am perceiving or ‘being’ underneath my own lens. From this place, where peace is revealed in the deep connection of two people, I mirror back the best I see in her, my great hope for her, my belief in her, my knowing that together, in this moment, we will move through this.
Connection as a preventative of violence
Shortly after Congresswoman Gabby Giffords and 17 others were assaulted with a firearm in Tucson, Arizona in 2011 and six people died from their wounds, the mayor of Tucson, Arizona asked for a meeting with the Administrator of the Federal Substance Abuse and Mental Health Services Administration (SAMHSA).
I recall being hopeful that some federal action step might be taken to move forward in a collective and positive direction after this tragedy. About 45 of us from around the country met at SAMHSA in Rockville, Maryland, the Tucson mayor and his wife joined us via phone.
There was much talk around what some communities have done in response to similar attacks, how we might be able to prevent such attacks and where we go from here, such as community dialogues, town meetings, etc.
I listened for a long while and then spoke and I would say the same thing today: People don’t act out in desperate acts of rage – be it homicide, massacre or suicide – when they know they are connected and belong to something bigger than themselves – be it family, community or some entity that gives their life meaning and purpose. I don’t believe this behavior occurs when people know that they belong in community, that they have a safety net, a place where they are being well thought of, cared about.
If people have somewhere safe to go when they feel big feelings, whatever those feelings are – anger, rage, isolation, anxiety, sadness, etc., they would not act out so desperately, at least they would be less likely to. The invitation is to think creatively and strategize about how we rebuild our communities so they everyone knows they belong, everyone is valued and has a place.
We can and must do a better job of connecting to our own hearts and to the hearts, minds and spirits of others.
I end with two simple and eloquent quotes from Albert Einstein, “We can not solve our problems with the same thinking we used when we created them” and “The ideals that have lighted my way, and time after time have given me new courage to face life cheerfully, have been Kindness, Beauty, and Truth.
Lauren Spiro’s vision of social justice and mental health liberation fuels her work of community building, developing our individual and collective capacity for feeling deeply connected, appreciating the vast creative intelligence of the human mind and creating pathways so everyone may come home. Diagnosed and institutionalized with chronic schizophrenia as a teenager, she has emerged as a visionary thinker, artist, and consultant dedicated to embodying inner peace to create global peace. She has an M.A. in Clinical/Community Psychology, has been featured on national media, co-founded Emotional CPR and two non-profit mental health corporations, is the former director of the National Coalition for Mental Health Recovery (www.ncmhr.org) and author of a recently published memoir, Living for Two: A Daughter’s Journey from Grief and Madness to Forgiveness and Peace. Join her at www.laurenspiro.wordpress.com or email Laurenspiro1@gmail.comRead More
This series of seven 90-minute webinars will feature presentations by people with “expertise by lived experience,” psychiatrists, and other professionals on a topic of critical importance: What do we know about withdrawal from psychiatric medications? The educational purpose of the series is to present information and insights that arise:
The Mad in America Continuing Education Project is continuing to evolve. Earlier in this year, we initiated a new way of providing our courses—a webinar format which has been going over quite well. Over 200 people took Dr. Chris Gordon and Keegan Arcure’s live course on Open Dialogue —and the numbers have continued to grow as people watch the webinar after the fact. So we have decided to ramp up our webinar offerings. We have produced two more so far; one on Oregon’s early psychosis intervention program, EASA (Early Assessment and Support Alliance), and another with Denmark’s Olga Runciman speaking on withdrawing from antipsychotic drugs.Read More
PeerRespite.net is a comprehensive online resource dedicated to dissemination and implementation efforts to help communities create effective, sustainable crisis alternatives through independent peer-run programs. Live & Learn, Inc created PeerRespite.net to provide a comprehensive online resource dedicated to dissemination and implementation efforts about peer respites, providing public access to information about research, technical assistance, and a program directory.
In May 2017, we launched the Guidebook for Peer Respite Self-Evaluation: Practical Steps and Tools to assist in building the evidence for peer respites.Read More